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More Adults Embraced At-Home Colorectal-Cancer Screening During Pandemic

NEW YORK (Reuters Health) – The COVID-19 pandemic has led to a shift in attitudes regarding colorectal cancer (CRC) screening in the United States, with a preference for at-home fecal occult-blood testing (FOBT) over colonoscopy, according to a new survey.

FOBT was seen as a “viable alternative” to colonoscopy during the pandemic, Dr. Emily Rivet of Virginia Commonwealth University (VCU) School of Medicine, in Richmond, said in an author interview from the American College of Surgeons (ACS) Clinical Congress, where the results were presented.

A key message is that, in a pandemic, “healthcare providers have to be willing to pivot away from what we’ve previously accepted as the standard or best practice or processes and come up with alternatives to provide the best care for patients,” said Dr. Rivet.

In a cross-sectional survey of 765 adults aged 50 and older, rates of completing a stool-based test were 32% before the pandemic compared with 50% during the pandemic.

By contrast, 44% of survey respondents who said they had colon screening during the pandemic underwent a colonoscopy – suggesting that people were substituting stool-based testing for colonoscopy, the authors say.

In support of this, two-thirds of respondents said they were concerned about COVID-19 exposure when scheduling colonoscopies, and 59% of them said this caused them to delay their screening.

Respondents said being offered protective equipment (gloves and masks), visits to smaller offices, or weekend screening appointments would increase their likelihood of following through with the colonoscopy.

However, 48% of respondents said they were willing to do an at-home FOBT as an alternative to colonoscopy; 93% of these individuals said they would be willing to have a follow-up colonoscopy if the FOBT was positive.

“Barriers to screening have increased during the pandemic, and we have to find ways to work with the community in order to increase screening rates. Our study found that people are doing stool-based at-home testing, and that they’re compliant and willing to do that,” Dr. Kristine Kenning, also of VCU, said in the author interview.

SOURCE: American College of Surgeons (ACS) Clinical Congress 2021, held October 23-27, 2021.

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