A real-world survey from Japan suggests that pandemic-related behavioral changes contributed to delayed colorectal cancer diagnosis, with patients who postponed medical visits during COVID-19 more likely to present with more advanced disease.
Researchers investigated how the COVID-19 pandemic affected healthcare-seeking behavior among patients undergoing colorectal cancer surgery, focusing on whether delays in screening or follow-up visits influenced disease progression.
Pandemic Disruptions Altered Patient Behavior
The study surveyed patients treated at two tertiary hospitals between January 2021 and June 2023. Of 83 eligible respondents, 8.4% reported pandemic-related behavioral changes, defined as postponement or cancellation of routine medical visits or additional cancer screenings.
Although this proportion appears modest, its clinical impact was notable. Patients who altered their healthcare behavior during the pandemic showed a trend toward more advanced colorectal cancer at diagnosis compared with those who maintained regular medical contact.
Symptoms Increased as Diagnoses Were Delayed
Clinical symptoms at presentation, particularly rectal bleeding, were significantly more common later in the study period, suggesting that cancers were increasingly diagnosed only after symptoms became unavoidable. This pattern reflects delayed detection rather than asymptomatic identification through screening programs.
Women were significantly more likely than men to report changes in healthcare behavior during the pandemic, identifying a potentially vulnerable subgroup. While the study was not powered to detect definitive stage differences, the association between behavioral changes and more advanced disease raises concerns about the long-term oncologic impact of missed screening opportunities.
Implications for Future Public Health Crises
The findings underscore how even short-term disruptions to preventive healthcare can have lasting consequences for cancer outcomes. The authors emphasize the importance of maintaining access to routine screening and encouraging timely medical evaluation during public health emergencies.
Targeted communication strategies, particularly for populations more likely to defer care, may help mitigate diagnostic delays in future crises. Ensuring continuity of cancer screening programs remains critical to preventing avoidable disease progression.
Reference
Fujino S et al. Behavioral changes and delayed colorectal cancer diagnosis during COVID-19: a real-world survey analysis. BMC Gastroenterol (2025). https://doi.org/10.1186/s12876-025-04550-2
