Comparative analysis of emergency department visits, hospitalizations, and mortality rates in colorectal cancer patients with positive fecal immunochemical test screening before and during the COVID-19 pandemic

The significant reduction in global colorectal cancer screenings due to the COVID-19 pandemic, which led to an increase in the diagnosis of advanced cases rate in short periods, prompted this comprehensive retrospective study at Chi Mei Medical Center (CMMC) in Southern Taiwan. Conducted from January 2017 to December 2022, the study aimed to understand the impacts of these disruptions on the healthcare system, particularly focusing on emergency department (ED) visits, hospitalizations, and mortality rates. Utilizing statistical methodologies such as Pearson's chi-square and Fisher's exact tests for categorical data, alongside the t-test and Wilcoxon rank-sum test for continuous data, this research compared the epidemiological and clinical outcomes across pre-pandemic and pandemic periods. Kaplan-Meier plots, coupled with log-rank tests, were employed to analyze mortality trends effectively. Among 3373 individuals who tested positive via fecal immunochemical tests (FIT), 96 patients were diagnosed with colorectal cancer before the COVID-19 pandemic, and 89 during it. The pathological staging indicated a consistent early-stage diagnosis rate of around 65% (p = 0.876). In addition, it revealed no significant changes in the frequency of ED visits and hospitalizations. Despite the pandemic's challenges and its extended duration, the median time to death and one-year mortality remained stable, underscoring the effectiveness of robust healthcare strategies in maintaining high-quality cancer screenings and managing patient care during public health crises. This research highlights the critical need for ongoing evaluations of healthcare protocols to mitigate the impacts of global health emergencies on diagnostic processes.