S554 Trends in Colorectal Cancer Screening and Incidence Before and After the COVID-19 Pandemic: A Retrospective Analysis Using the TriNetX US Database

Introduction: The coronavirus disease 2019 (COVID-19) pandemic disrupted routine healthcare services worldwide, including preventive cancer screening. This retrospective study aimed to evaluate the incidence of colon cancer screening and its association with new colorectal cancer (CRC) diagnoses before and after the onset of the COVID-19 pandemic. Methods: We performed a retrospective cohort study using data from the TriNetX US database between 2015 and 2024. Annual trends in colon cancer screening rates and newly diagnosed CRC cases were extracted and reported as percentages of the eligible population. We compared the pre-pandemic period (2015–2019), the pandemic year (2020), and the post-pandemic period (2021–2024) to assess temporal patterns and associations between screening disruption and CRC incidence. Results: A total of 3,612,038 patients underwent colon cancer screening from 2015 to 2024, during which 346,448 new CRC cases were diagnosed. Colon cancer screening increased from 0.531% in 2015 to 1.439% in 2024 (P < 0.001), while CRC incidence rose from 0.065% to 0.133% over the same period (P < 0.001). In 2020, screening incidence dropped to 0.608%, down from 0.754% in 2019, marking a 19.4% decrease, coinciding with the first year of the COVID-19 pandemic. CRC incidence initially decreased slightly to 0.072% in 2020, but rose in subsequent years, peaking at 0.133% in 2024, a 104.6% increase compared to 2015. New CRC cases among non‐Hispanic individuals increased from 0.06% in 2015 to 0.123% in 2024, while the Hispanic group saw a rise from 0.04% to 0.093% over the same period (P < 0.001). The Asian group experienced the largest relative increase, with CRC incidence climbing from 0.529% in 2015 to 1.353% in 2024 (P < 0.001). Conclusion: Colon cancer screening was significantly disrupted in 2020 due to the COVID-19 pandemic, leading to a temporal rise in CRC diagnoses in the following years. These findings highlight the importance of maintaining preventive care services during public health emergencies to avoid delayed diagnoses and adverse outcomes in cancer care.