Minireviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Aug 15, 2022; 14(8): 1490-1498
Published online Aug 15, 2022. doi: 10.4251/wjgo.v14.i8.1490
How the COVID-19 pandemic has affected the colorectal cancer screening in Italy: A minireview
Alessandro Fancellu, Simone Veneroni, Antonio Santoru, Arianna Meloni, Valeria Sanna, Giorgio C Ginesu, Giulia Deiana, Panagiotis Paliogiannis, Chiara Ninniri, Teresa Perra, Alberto Porcu
Alessandro Fancellu, Simone Veneroni, Antonio Santoru, Arianna Meloni, Giorgio C Ginesu, Giulia Deiana, Chiara Ninniri, Teresa Perra, Alberto Porcu, Department of Medical, Surgical, and Experiemental Sciences, Unit of General Surgery 2-Clinica Chirurgica, University of Sassari, Sassari 07100, Italy
Valeria Sanna, Unit of Oncology, AOU Sassari, Sassari 07100, Italy
Panagiotis Paliogiannis, Department of Medical, Surgical, and Experimental Sciences. Unit of Pathology, University of Sassari, Sassari 07100, Italy
Author contributions: Fancellu A conceived the paper and drafted the manuscript; Veneroni S made the literature search and contributed to the drafting of the manuscript; Santoru A and Meloni A searched the web sources for relevant issues regarding the topic of the article; Ginesu GC critically resumed the data from the studies; Deiana G contributed to the literature search; Paliogiannis P contributed to critically evaluate the literature data; Ninniri C participated in the analysis and interpretation of the data; Perra T revised the article critically for important intellectual content; Sanna V prepared the figures and tables; Porcu A coordinated and supervised the writing of the paper.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Alessandro Fancellu, FACS, MD, PhD, Associate Professor, Department of Medical, Surgical, and Experiemental Sciences, Unit of General Surgery 2-Clinica Chirurgica, University of Sassari, V.le San Pietro 43, Sassari 07100, Italy. afancel@uniss.it
Received: March 28, 2022
Peer-review started: March 28, 2022
First decision: May 11, 2022
Revised: May 23, 2022
Accepted: July 8, 2022
Article in press: July 8, 2022
Published online: August 15, 2022
Processing time: 135 Days and 5.2 Hours
Abstract

The coronavirus disease 2019 (COVID-19) pandemic has caused detrimental effects on many aspects of healthcare practice. Screening programs for the commonest malignancies, namely colorectal cancer (CRC), breast cancer and cervical cancer have been discontinued or interrupted since the beginning of restriction measures aimed to limit transmission of the new coronavirus infection. Robust evidence exists in favour of the role of screening campaigns in reducing mortality from CRC. In fact, the majority of pre-malignant lesions of the colon and rectum can be diagnosed with colonoscopy and treated by endoscopic or surgical resection. Besides, colonoscopy screening allows the diagnosis of CRCs in their pre-clinical stage. Italy was one of the first European countries where a high level of COVID-19 infections and deaths was observed, and one of the first where lockdowns and strict measures were adopted to reduce the risk of COVID-19 diffusion among the population. A systematic review of the literature was performed, including the PubMed, Scopus, Web of Sciences, and Reference Citation Analysis databases, with the aim of critically evaluating the impact of the COVID-19 pandemic on CRC screening in Italy. We found that reduction of CRC screening activity surpassed 50% in most endoscopic units, with almost 600000 fewer CRC screening exams conducted in the first 5 mo of 2020 vs the same period of 2019. While the consequences of the discontinuation of endoscopy screening for the prognosis and mortality of CRC will be evident in the next few years, recent data confirm that CRC is currently treated at a more advanced stage than in the pre-COVID-19 era. Since delays in CRC prevention and early diagnosis may translate to increased CRC-specific mortality, world healthcare systems should adopt strategies to maintain the regularity of CRC screening during subsequent peaks of the COVID-19 pandemic, or future events that might hamper screening programs.

Keywords: COVID-19; Colorectal cancer screening; Italy; Minireview

Core Tip: Screening is a key component of colorectal cancer control. As in the rest of the world, the coronavirus disease 2019 (COVID-19) emergency has interrupted the regular delivery of cancer screening services in Italy. As a consequence, significant delays in the diagnosis and treatment of malignant and pre-malignant lesions have occurred, with possible effects on disease prognosis. Screening activity has gradually resumed after the first wave of the pandemic. The healthcare system is called on to be prepared to prevent the potential suspension of new rounds of screening during the COVID-19 pandemic or future extraordinary events that might hamper screening programs.