The impact of extended invitation intervals on stage distribution of screen-detected and interval cancer within the Dutch colorectal cancer screening program

Abstract

This study investigates the impact of extended invitation intervals on the stage distribution of screen-detected and interval colorectal cancers (CRCs) in the Netherlands' fecal immunochemical test (FIT)-based screening program during the COVID-19 pandemic. Using data from individuals with negative FIT results in 2017–2019 and subsequent screening round in 2019–2021, we examined whether delays of up to 6 months affected CRC stage at diagnosis. We performed multivariate logistic regression to assess the association between invitation intervals and cancer stage. Our analysis found no significant difference in stage distribution for both screen-detected and interval CRCs despite the delays. Specifically, odds ratios for late-stage cancer remained close to 1 across various intervals, indicating minimal impact of extended invitation times. These results suggest that the short-term delays caused by the pandemic did not significantly affect the performance of the CRC screening program. This highlights the program's ability to adapt to temporary disruptions while maintaining effective early cancer detection. Our findings support the notion that such disruptions, when managed appropriately, do not substantially compromise the quality of screening outcomes, reinforcing the resilience and flexibility of CRC screening programs in the face of health crises.