COVID-19 Pandemic Altered Patient Attitudes Towards At-Home CRC Screening

At the American College of Surgeons, Clinical Congress 2021, in October, 2021, Kristine Kenning, MD, chief general surgery resident at Virginia Commonwealth University, presented results from a survey among 765 age-eligible (50 and older) adults for colorectal cancer (CRC) screening. Her team found that about 30% of those who participated on the survey had completed stool-based tests when compared to before the pandemic.

The study also looked at how barriers to screening changed before and after the pandemic. They found about a 5% increase in the percentage of unemployed respondents, from 2.6% to 7.4%. Of the 41% of respondents who were concerned about co-pays, 57.6% said they delayed undergoing screening as a consequence.

It was also found that: 

• 59% of respondents delayed their colonoscopy out of concern for COVID-19 exposure
• 48.1% were open to at-home fecal occult blood tests (FOBT) as an alternative 
  • 93% of them would get a follow up colonoscopy if the FOBT was positive 

FOBT analyses blood in feces that is not visible to the naked eye. A positive result for this test would indicate lesions present in the digestive tract.

Impact of the Pandemic

Perception towards at-home tests and colonoscopies have changed as a result of the pandemic. More people now than before are uncomfortable undergoing a colonoscopy because of the associated costs and potential for exposure to COVID-19. At-home tests such as FOBTs may be potential alternatives to a colonoscopy. 

Dr. Kenning explained the significance of her research findings in the Clinical Congress 2021 press release. “The key message from our findings is that barriers to screening have increased during the pandemic, and we have to find a way to work with the community to increase those rates. Our study found that people are compliant with, and willing to do, home-based fecal occult blood testing. This test provides a very important way for us to increase screening for colorectal cancer.”

Dr. Kenning noted that a larger survey is in the planning with principal investigator Carrie Miller, PhD, MPH, to further explore the changes in attitudes towards CRC screening.

Gargi Patel is a Colon Cancer Prevention Intern with the Colon Cancer Foundation.