Copyright ©The Author(s) 2021.
World J Gastrointest Oncol. Apr 15, 2021; 13(4): 238-251
Published online Apr 15, 2021. doi: 10.4251/wjgo.v13.i4.238
Table 1 Comparison of colorectal cancer screening tests during the coronavirus disease 2019 pandemic
Stool based testing
Prioritization “risk stratification” of patient population can ensure those at highest risk for developing CRC can still have timely access to tests[39]Widespread use of FIT may lower CRC mortality rates[49], some models indicate similar benefit to colonoscopy[85]
Allows longer interval between colonoscopies[33]Cheaper and less invasive compared to colonoscopy[36]
Visualization and, if needed, polypectomy can be completed within the same procedure[33]Reduces scheduling of colonoscopies, lessening patient exposures[34]
Can be completed at home and sent back to the laboratory[33]
Needs pre-procedure visits[36]Short interval between tests[33]
Loss of health insurance may limit patient ability to pay for procedures[36]Positive individuals still need to undergo colonoscopy, which may be subject to out-of-pocket costs[33]
Little consensus on optimal threshold cutoff value[86]
Implementing on a larger scale requires establishment systems in place[34]
Table 2 Risk factors to consider for risk stratification model of colorectal cancer based on recent studies[52,53,55]
Demographic characteristics
Older age, obesity, male sex, family history of CRC, race/ethnicity
Personal medical historyHypertension, diabetes
LifestyleSmoking, alcohol, sedentary lifestyle
DietRed meat consumption, processed meat consumption, low fiber diet
Table 3 Advantages and disadvantages of open access colonoscopies
No pre-colonoscopy consultationsPromotes development of an electronic risk-assessment systemIncreased rates of inappropriate surveillance guidelinesDependent on hospital infrastructure to facilitate OACHigh rates of no-shows and cancellations
Decreased healthcare expenditureShared medical records amongst patient’s care teamMay take away from limited available resourcesLoss of appointment spots needed to make up for COVID-19 backlog
Patients save time and moneyIdentifies high risk individuals
Decreased patient load on gastroenterologistsRecommends screening based on most recent CRC guidelines