March is the month dedicated to the Prevention of Colorectal Cancer, but the investigation of FISMAD highlights alarming data. As a result of the Covid-19 pandemic, thousands of diagnoses of digestive system cancer have been lost: in the Center (-16.5%) and in Northern Italy (-13.7%) the greatest number of missed diagnoses.
FISMAD – Italian Federation of Digestive System Diseases Society recalls that colorectal, stomach and pancreatic cancers respectively represent the second, sixth and seventh most frequent cancer in both sexes in Italy in 2020. These are alarming data, which rekindle the spotlight on the importance of prevention, a powerful weapon for defeat these pathologies.
“The data that emerged from our survey show how the reductions in the volume of specialist gastroenterological diagnostic activities due to the Covid-19 pandemic have led to a considerable number of lost diagnoses of the three ‘big killers’, namely stomach cancers, colorectal and pancreas ”, he points out Elisabetta Buscarini, President of FISMAD. “If there is no turnaround, the effects of the Covid-19 pandemic could drastically undermine the protective effect of CCR screening accumulated over two decades and reverse the observed positive trends for colorectal and stomach cancers. For this we also appeal to our political class ”.
The survey carried out by FISMAD throughout the national territory shows that, compared to the three-year period 2017-19, gastric cancer diagnoses decreased by 15.9% in 2020, those of colorectal cancer by 11.9% and those of pancreatic cancer by 9.9%. In particular, the greatest percentage of missed CRC diagnoses was found in the Center (-16.5%) and in Northern Italy (-13.7%), with the South (-4.1%) clearly distanced.
The number of lost diagnoses of stomach cancer is also significant: -19% in the North, -9.4% in the South. As regards pancreatic cancers, the North recorded the greatest decline, with 14.1% fewer cases. diagnosed.
Alarming numbers: – 6,700 advanced adenomas and -1,168 cases of colorectal cancer
Data on colorectal cancer they also reflect the consequences of the interruption of screening programs throughout Italy. The suspension and delays in organized screening for colorectal cancer have led to alarming consequences. Failure to diagnose the screening process: 1,168 cases of colorectal cancer – and 6,700 advanced adenomas were lost on diagnosis across the country due to screening tests being halved (-52%). A diagnostic delay that emerges with alarming clarity from the latest report of the National Screening Observatory (ONS) and taken up by FISMAD – Federation of Digestive System Diseases Society, based on the comparison between the number of diagnoses made from January to October 2020 with those of the same period in 2019.
In Lombardy Screening down by 78%, with delays of up to 7 months
The data published by the ONS estimate a screening delay of 4.7 months across the country, with peaks of 7.1 and 8.4 months respectively in Lombardy and Calabria. In Lombardy, 743 thousand fewer invitations were sent than in 2019, with a concomitant decrease in screening exams of 78%, significantly higher than the national one (-52%).
Less propensity to screening for 1 out of 5 Italians
In addition to the significant reduction in invitations to screening, the high perception of infectious risk also contributed to discourage users from adhering to screening for fear of going to a healthcare facility: in fact, the assessments reported showed a reduction in the propensity to participation in colorectal screening of 20%.
The clinical consequences
From a clinical point of view, data show that the major consequences of non-diagnosis translate into a possible 3% increase in the stage at diagnosis of colorectal cancer, a possible 12% increase in mortality due to delays beyond 12 months.