Colorectal cancer screening in the COVID-19 era

Table 1 Comparison of colorectal cancer screening tests during the coronavirus disease 2019 pandemic

Colonoscopy	Stool based testing
Advantages
Prioritization “risk stratification” of patient population can ensure those at highest risk for developing CRC can still have timely access to tests[39]	Widespread use of FIT may lower CRC mortality rates[49], some models indicate similar benefit to colonoscopy[85]
Allows longer interval between colonoscopies[33]	Cheaper and less invasive compared to colonoscopy[36]
Visualization and, if needed, polypectomy can be completed within the same procedure[33]	Reduces scheduling of colonoscopies, lessening patient exposures[34]
	Can be completed at home and sent back to the laboratory[33]
Disadvantages
Needs pre-procedure visits[36]	Short interval between tests[33]
Loss of health insurance may limit patient ability to pay for procedures[36]	Positive individuals still need to undergo colonoscopy, which may be subject to out-of-pocket costs[33]
	Little consensus on optimal threshold cutoff value[86]
	Implementing on a larger scale requires establishment systems in place[34]

FIT: Fecal immunochemical test; CRC: Colorectal cancer.