Gastrointestinal Cancer

特別演講（一）

IMPACTS OF COVID-19 ON LONG-TERM CONSEQUENCE OF GASTROINTESTINAL CANCER

Hsiu-Hsi Chen（陳秀熙） 國立臺灣大學

As of March 2022, COVID-19 pandemic has afflicted 450 million people and claimed 6 million tolls worldwide. Such a tremendous global disease burden (GBD) not only yielded direct health impacts of disability adjusted life years (abbreviated as DALYs) but also spawned indirect health impacts of long-term consequences in the aftermath of COVID-19. The former included years of life lost and years of disability lost), amounting to around 900 billion dollars (USD), approximately 30 years of expenditure spent in Taiwan National Health Insurance (NHS). The latter is meant to long-term health loss due to the postponement of primary prevention on non-communicable disease (NCD), the failure of early detection, and the delayed diagnosis and treatment caused by the restricted nonpharmaceutical interventions (NPIs) that have been used to mitigate and control the COVID-19 pandemic. In this speech, I would use a systematic framework to evaluate the long-term consequence of COVID-19 on gastrointestinal cancer. The first aspect is to estimate DALYs associated with the leading causes of death from gastrointestinal cancer that are attributed to COVID-19 pandemic illustrated by a series of international experiences on procrastinate execution of primary prevention, secondary prevention, and tertiary prevention during COVID-19 pandemic. An illustration on population-based cancer screening with fecal immunochemical test (FIT) will be provided for quantitatively assessing how various scenarios of screening delays are associated with the capacity for primary screening and full time equivalent (FTE) for colonoscopy and impact long-term outcomes. The second aspect of long-term consequence is that the distribution of health service type for those who have been detected, diagnosis, and treated with delay as mentioned above would be shifted from the essential care to more rely on the state-of-the-art treatment and therapy in order to improve survival. Such a shift pattern would make medical expenditure soar up in the future. Both aspects of consequences are further aggravated by the baby boomer age of high volume of population and high incidence of gastrointestinal cancer.