Colorectal cancer (CRC) is the third most common cancer in Québec, Canada, and the second and third cause of cancer death in males and females, respectively.1 Québec, a province with a population of 8.5 million, was hard-hit during the first wave of the COVID-19 pandemic (March–July 2020). A status of public health emergency was declared in Québec on 16th March 2020. All cancer screening programmes and elective procedures were, therefore, suspended on that date.
MATERIALS AND METHODS
Ministry of Health of Québec data related to cancer screening programmes and diagnosis during the periods of March 2019 to February 2020 and March 2020 to February 2021 were recently reported.2 The 4-month period (April–July) of 2020 and 2019 were compared to study the impact of the COVID-19 pandemic on screening and diagnosis of CRC.
From April to July 2020, faecal occult blood tests decreased by 67.26%, colonoscopy procedures by 57.80%, and CRC surgery by 29.50% compared with the same period from 2019. The waiting list for colon endoscopy increased by 210% from April to July 2020 and by 141% from August to October 2020. With resumed activities from August to October 2020, no catching-up with the delays was seen. There were 5% fewer faecal occult blood tests, 11.4% fewer colonoscopies, and 28.0% fewer CRC surgeries compared to the same period in 2019.
The COVID-19 pandemic affected screening and lead to unprecedented delays in cancer screening, diagnosis, and treatment. Catching-up with the delays is a challenge for health authorities, and adding substantial resources is highly required. The impact of the off-loading of diagnostic and surgical activities on cancer mortality is hard to be estimated but is likely to be significant.