Intest Res.  2023 Oct;21(4):500-509. 10.5217/ir.2023.00004.

The elderly population are more vulnerable for the management of colorectal cancer during the COVID-19 pandemic: a nationwide, population-based study

• Kang HS
• Jeon SH
• Park SB
• Youn JY
• Kwak MS
• Cha JM

• KMID: 2547200
• DOI: http://doi.org/10.5217/ir.2023.00004

Abstract

Background/Aims
The impact of coronavirus disease 2019 (COVID-19) on the management of colorectal cancer (CRC) may worse in elderly population, as almost all COVID-19 deaths occurred in the elderly patients. This study aimed to evaluate the impact of COVID-19 on CRC management in the elderly population.
Methods
The numbers of patients who underwent colonoscopy, who visited hospitals or operated for CRC in 2020 and 2021 (COVID-19 era) were compared with those in 2019, according to 3 age groups (≥70 years, 50–69 years, and ≤49 years), based on the nationwide, population-based database (2019–2021) in South Korea.
Results
The annual volumes of colonoscopy and hospital visits for CRC in 2020 were more significantly declined in the old age group than in the young age group (both P<0.001). In addition, the annual volume of patients operated for CRC numerically more declined in old age group than in young age group. During the first surge of COVID-19 (March and April 2020), old age patients showed statistically significant declines for the monthly number of colonoscopies (–46.5% vs. –39.3%, P<0.001), hospital visits (–15.4% vs. –7.9%, P<0.001), CRC operations (–33.8% vs. –0.7%, P<0.05), and colonoscopic polypectomies (–41.8% vs. –38.0%, P<0.001) than young age patients, compared with those of same months in 2019.
Conclusions
Elderly population are more vulnerable for the management of CRC during the COVID-19 pandemic. Therefore, the elderly population are more carefully cared for in the management of CRC during the next pandemic.

Keyword

Age groups; Colonoscopy; Colorectal neoplasms; COVID-19; Mass screening

Figure

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  Fig. 1. The monthly change (%) of colonoscopy, hospital visit for colorectal cancer (CRC) and operation for CRC during the first surge of coronavirus disease 2019 (March and April of 2020), compared with those in 2019, more significantly declined in middle and old age groups than young age group (reference). Their statistical significance was expressed with aP<0.05, bP<0.001.

• 

  Fig. 2. The percentage change of colonoscopy claim in 2020 and 2021, compared to those of 2019, were more significantly declined in middle and old age groups than those in young age group in the first epidemic wave, but slowly recovered in all age groups even in the 2nd-4th epidemic waves. Statistical significance was expressed with aP<0.05, bP<0.001.

• 

  Fig. 3. The percentage change of hospital visit in 2020 and 2021, compared to those of 2019, were significantly declined in old age group than those in young age group in the first epidemic wave, but slowly recovered in all age groups even in the 2nd-4th epidemic waves. Statistical significance was expressed with aP<0.05, bP<0.001.

• 

  Fig. 4. The percentage change of colorectal cancer (CRC) operation in 2020 and 2021, compared to those of 2019, were significantly declined in old age group than those in young age group in the first epidemic wave, but slowly recovered in all age groups even in the 2nd-4th epidemic waves. Statistical significance was expressed with aP<0.05, bP<0.001.

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