Malignant polyps in the COVID-19 era: a population-based analysis.

Area of Science:

• Oncology
• Gastroenterology
• Public Health

Background:

• Malignant polyps are precursors to colorectal adenocarcinoma.
• The COVID-19 pandemic caused widespread healthcare resource rationing in 2020.
• This led to deferrals in colonoscopy procedures crucial for early malignant polyp detection.

Purpose of the Study:

• To assess the impact of COVID-19-related healthcare deferrals on malignant polyp diagnoses.
• To analyze trends in malignant polyp detection during the pandemic.

Main Methods:

• Population-wide analysis of 2079 malignant polyps diagnosed in Queensland, Australia (2011-2020).
• Regression analysis with 95% prediction intervals to compare 2020 diagnoses with previous years.
• Univariate statistical analysis of patient, procedural, and pathological variables.

Main Results:

• Significantly fewer malignant polyps (211) were diagnosed in 2020 than predicted (P < 0.001).
• Malignant polyps diagnosed in 2020 were less likely to be from private settings (P < 0.001) and showed less submucosal invasion (P = 0.017).
• No significant difference in management strategies (polypectomy, resection) was observed between 2011-2019 and 2020.

Conclusions:

• A significant decrease in malignant polyp diagnoses occurred in 2020, likely due to delayed colonoscopies.
• An anticipated increase in advanced colorectal adenocarcinomas is expected in 2021 and beyond.
• This trend will likely increase the strain on healthcare resources amidst the ongoing pandemic.