☆ 4.5 Article

The impact of the first peak of the COVID-19 pandemic on colorectal cancer services in England and Wales: A national survey

COLORECTAL DISEASE (2021)

Journal

COLORECTAL DISEASE

Volume 23, Issue 7, Pages 1733-1744

Publisher

WILEY

DOI: 10.1111/codi.15622

Keywords

cold site; colorectal cancer; COVID-19

Funding

NHS England
Welsh Government
National Institute for Health Research (NIHR) Advanced Fellowship [NIHR300599]
National Institutes of Health Research (NIHR) [NIHR300599] Funding Source: National Institutes of Health Research (NIHR)

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Abstract

Access to 'cold sites', as well as regional coordination, clear communication and strong leadership, were found to be pivotal in maintaining capacity for diagnosis and treatment of CRC during the COVID-19 surge.

Aim The object of this work was to study how National Health Service hospitals in England and Wales aimed to maintain effective and safe colorectal cancer (CRC) services during the first peak of the COVID-19 pandemic (April 2020). Method A national survey was performed among all 148 hospitals providing CRC services. Information was collected about changes in referrals, diagnostic, staging and therapeutic procedures, as well as whether there was access to a 'cold site' (a hospital facility free of COVID-19). Clinicians in each hospital were also asked to give the 'single most important lesson learned' about keeping services safe and effective. Results Full responses were received from 123 (83%) hospitals, and information about 'cold sites' was available for 146 (99%). Eighty hospitals (54%) had access to a 'cold site' and this was increased in regions with higher COVID-19 infection rates (p <0.001). Of the 123 responding hospitals, 105 (85%) indicated that referrals of patients with suspected CRC had dropped by at least 30%, and 69 (56%) indicated that treatment plans were altered in at least 50% of CRC patients. However, 'cold site' availability protected the capacity for diagnostic colonoscopy (p = 0.013) and CRC resection (p = 0.010). Many 'lessons learned' highlighted the importance of adequate structural service organization, often mentioning 'cold sites' and regional coordination as examples, good communication and triage of patients based on clinical urgency. Conclusion Access to 'cold sites', as well as regional coordination, clear communication and strong leadership, were found to be pivotal in maintaining capacity for diagnosis and treatment of CRC during the COVID-19 surge.

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Colorectal Cancer Screening During the COVID-19 Pandemic

Leigh H. Simmons, Dominick L. Frosch, Marilyn M. Schapira, Michael J. Barry, Karen Sepucha

Summary: Shared decision-making (SDM) is an important approach to help patients make informed decisions about preventive health interventions. This article illustrates the use of SDM in a case of colorectal cancer (CRC) screening. By offering multiple options and respecting the patient's preferences, SDM plays a key role in understanding and addressing the patient's concerns, ultimately leading to a favorable outcome.

JOURNAL OF GENERAL INTERNAL MEDICINE (2022)