筛查结肠直肠癌（CRC）通过去除癌前病变和早期癌症的检出降低了癌症负担。COVID-19大流行病在全球范围内破坏了有组织的CRC筛查计划，其中一些计划完全暂停筛查，其他计划则出现参与率和诊断后续状况的显著下降。本研究估计了筛查中断对CRC结果的全球影响以及补救筛查的潜在效果。在29个国家检测到了有组织筛查计划，并提取了2020年参与率和与COVID相关的筛查变化的数据（如有）。使用四个独立的微观模拟模型（ASCCA、MISCAN-Colon、OncoSim和Policy1-Bowel）根据2020年筛查参与度下降的程度，估计了对CRC患病和死亡的长期影响。对于没有2020年参与数据的国家，根据超过正常死亡率来估计筛查变化情况。还模拟了涉及2021年额外筛查的补救策略。 在直接数据可用的国家/地区中，估计2020年有组织CRC筛查量在国家/地区水平上下降了1.3-40.5%。全球范围内，估计与COVID相关的筛查下降导致2020年少执行了740万次粪便筛查。在没有任何组织的补救筛查情况下，这将导致2020年至2050年全球范围内额外13000例CRC病例和7900例死亡；根据补救筛查，可以预防79%的附加病例和85%的附加死亡。 COVID-19相关的筛查中断将导致超标的CRC病例和死亡，但适当实施的补救筛查可以将负担减少80%以上。认真管理任何中断是提高结肠直肠癌筛查计划韧性的关键。 作者披露了以下资金支持该文章的研究、作者权和/或出版：该研究得到新南威尔士癌症委员会、加拿大卫生部和荷兰国家公共卫生与环境研究所的支持。© 2023 The Authors.

Screening for colorectal cancer (CRC) decreases cancer burden through removal of precancerous lesions and early detection of cancer. The COVID-19 pandemic has disrupted organised CRC screening programs worldwide, with some programs completely suspending screening and others experiencing significant decreases in participation and diagnostic follow-up. This study estimated the global impact of screening disruptions on CRC outcomes, and potential effects of catch-up screening.Organised screening programs were identified in 29 countries, and data on participation rates and COVID-related changes to screening in 2020 were extracted where available. Four independent microsimulation models (ASCCA, MISCAN-Colon, OncoSim, and Policy1-Bowel) were used to estimate the long-term impact on CRC cases and deaths, based on decreases to screening participation in 2020. For countries where 2020 participation data were not available, changes to screening were approximated based on excess mortality rates. Catch-up strategies involving additional screening in 2021 were also simulated.In countries for which direct data were available, organised CRC screening volumes at a country level decreased by an estimated 1.3-40.5% in 2020. Globally, it is estimated that COVID-related screening decreases led to a deficit of 7.4 million fewer faecal screens performed in 2020. In the absence of any organised catch-up screening, this would lead to an estimated 13,000 additional CRC cases and 7,900 deaths globally from 2020 to 2050; 79% of the additional cases and 85% of additional deaths could have been prevented with catch-up screening, respectively.COVID-19-related disruptions to screening will cause excess CRC cases and deaths, but appropriately implemented catch-up screening could have reduced the burden by over 80%. Careful management of any disruption is key to improving the resilience of colorectal cancer screening programs.The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Cancer Council New South Wales, Health Canada, and Dutch National Institute for Public Health and Environment.© 2023 The Authors.