Fecal occult blood tests at home may ease colorectal cancer screening in COVID-19 pandemic: Study

USA: Home-administered fecal occult blood tests (FOBT) may provide a useful workaround tool in people hesitant to come into the hospital or an outpatient center to get a colonoscopy, a recent study has suggested. The findings are important as the COVID-19 pandemic has impacted patients' willingness to keep appointments for non-COVID-19 illnesses. 

The study findings were presented at the American College of Surgeons Clinical Congress held virtually from Oct. 23-27, 2021. 

The key message from our findings is that barriers to screening have increased during the pandemic, and we have to find a way to work with the community to increase those rates," said Dr. Kenning, chief general surgery resident at Virginia Commonwealth University (VCU) School of Medicine, Richmond. "Our study found that people are compliant with, and willing to do, home-based fecal occult blood testing. This test provides a very important way for us to increase screening for colorectal cancer."

The American College of Gastroenterology clinical guidelines recommend colonoscopy for colorectal cancer evaluation and following a positive FOBT with a colonoscopy. About 148,000 cases of colorectal cancers are newly diagnosed in the United States each year, the American Cancer Society reports, and they account for 53,000 deaths.

The researchers performed a cross-sectional survey assessing attitudes toward CRC screening during the pandemic in 745 patients eligible for screening and found that their respondents reported a higher completion of stool tests pre-COVID than the American Cancer Society reported,2 32 percent vs. 11 percent. During the pandemic, 50 percent of respondents said they completed the FOBT. By contrast, 44 percent of survey respondents who said they had colon screening during the pandemic underwent a colonoscopy. This practice appears to demonstrate substitution of stool-based testing for colonoscopy, Dr. Kenning noted.

"Our study looked at attitudes toward colorectal cancer screening and how they were impacted during the pandemic, both related to concerns about the pandemic as well as to economic impacts," senior author Emily B. Rivet, MD, MBA, FACS, said. "What we learned is that fecal occult blood testing was seen by patients as a viable alternative to conventional screening colonoscopy." Dr. Rivet is an associate professor in the department of surgery, division of colorectal surgery, and an affiliated professor of internal medicine at VCU School of Medicine.

Reference:

Citation: Kenning K. et al, COVID-19 Pandemic Impact on Colorectal Cancer Screening. Scientific Forum Presentation. American College of Surgeons Clinical Congress 2021.