Supplementary Tables 1-2 and Supplementary Figures 1-4 from Impact and Recovery from COVID-19–Related Disruptions in Colorectal Cancer Screening and Care in the US: A Scenario Analysis
posted on 2025-11-26, 13:23authored byRosita van den Puttelaar, Iris Lansdorp-Vogelaar, Anne I. Hahn, Carolyn M. Rutter, Theodore R. Levin, Ann G. Zauber, Reinier G.S. Meester
<p>Supplementary Table 1. Published estimates of the decrease in CRC screening rates as a result of the COVID-19 pandemic (March-September) identified by our literature search. Supplementary Table 2. Published estimates of the decrease in CRC diagnoses rates as a result of the COVID-19 pandemic (March-September) identified by our literature search. Some studies distinguish between new and all diagnoses. Supplementary Figure 1. Simulated screening in MISCAN: screened with any test (A), fecal immunochemical testing in the past year (FIT) (B), endoscopy in the past 5 years (C), endoscopy in the past 10 years (D), proportion of endoscopies that was colonoscopy (E), and percentage up-to-date with screening (F). Supplementary Figure 2. Simulated incidence (A-C) and mortality rates (D-F) for all three recovery periods were smoothed using a logarithmic regression model. Supplementary Figure 3. Severity of disruption in preventive (panel A) and diagnostic (panel B) services during the disruption period. Supplementary Figure 4. Cumulative excess CRC cases (A) and deaths (B) compared to a scenario without pandemic-induced delays over time for different recovery scenarios.</p>
Funding
National Cancer Institute (NCI)
United States Department of Health and Human Services
Many colorectal cancer–related procedures were suspended during the COVID-19 pandemic. In this study, we predict the impact of resulting delays in screening (colonoscopy, FIT, and sigmoidoscopy) and diagnosis on colorectal cancer–related outcomes, and compare different recovery scenarios.
Using the MISCAN-Colon model, we simulated the US population and evaluated different impact and recovery scenarios. Scenarios were defined by the duration and severity of the disruption (percentage of eligible adults affected), the length of delays, and the duration of the recovery. During recovery (6, 12 or 24 months), capacity was increased to catch up missed procedures. Primary outcomes were excess colorectal cancer cases and –related deaths, and additional colonoscopies required during recovery.
With a 24-month recovery, the model predicted that the US population would develop 7,210 (0.18%) excess colorectal cancer cases during 2020–2040, and 6,950 (0.65%) excess colorectal cancer–related deaths, and require 108,500 (8.6%) additional colonoscopies per recovery month, compared with a no-disruption scenario. Shorter recovery periods of 6 and 12 months, respectively, decreased excess colorectal cancer–related deaths to 4,190 (0.39%) and 4,580 (0.43%), at the expense of 260,200–590,100 (20.7%–47.0%) additional colonoscopies per month.
The COVID-19 pandemic will likely cause more than 4,000 excess colorectal cancer–related deaths in the US, which could increase to more than 7,000 if recovery periods are longer.
Our results highlight that catching-up colorectal cancer–related services within 12 months provides a good balance between required resources and mitigation of the impact of the disruption on colorectal cancer–related deaths.