Long-Term Health and Economic Impacts of COVID-19 Disruptions on Bowel Cancer Inequalities in Victoria, Australia - A Modelling Study

Sep 22, 2026

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The study evaluates how COVID-19 disruptions to colorectal cancer (CRC) services affect long-term health inequalities and healthcare costs in Victoria, Australia, focusing on groups that were historically under-screened. Using a Markov microsimulation model (PRISM-CRC) with socioeconomic quintiles for ages 50–74 from 2023–2037, the analysis projects CRC incidence, mortality, and costs under disruption and no-disruption scenarios. Screening status, diagnosis stage, and survival are parameterized from linked VCR data (2009–2021). After COVID-19, CRC cases and deaths rise across all quintiles, greatest in disadvantaged groups, indicating intensified social gradients and highlighting targeted screening interventions.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Introduction

Methods

Results

Conclusion

Introduction

Background on COVID-19 disruptions and CRC services

Screening and participation disparities

Cancer Medicine RESEARCH ARTICLE OPEN ACCESS Long-Term Health and Economic Impacts ofCOVID-19 Disruptions on Bowel Cancer Inequalities in Victoria, Australia: A Modelling Study Anita Lal1 | Eliza Mudford1 | Bedasa Taye Merga1 | Lan Gao1 | Craig Sinclair2 | Kate Broun2 | Justin M. Yeung3,4 | Nikki McCaffrey1,2 1Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia | 2Cancer Council Victoria, Melbourne, Victoria, Australia | 3Department of Colorectal Surgery, Western Health, Melbourne, Victoria, Australia | 4Department of Surgery, Western Precinct, University of Melbourne, Melbourne, Victoria, Australia Correspondence: Anita Lal ([anita.lal@deakin.edu.au](anita.lal@deakin.edu.au)) Received: 8 May 2025 | Revised: 5 February 2026 | Accepted: 2 April 2026 Keywords: colorectal cancer | COVID-19 | disparities | inequalities | modelling | prevention | screening | socioeconomic ABSTRACT Introduction: The COVID-19 pandemic significantly disrupted colorectal cancer (CRC) diagnosis and treatment globally. Most research on long-term impacts has focused on population-level outcomes, overlooking disparities in under-screened groups. This study examines the long-term effects of COVID-19 disruptions on health inequalities and healthcare costs in Victoria, Australia. Methods: A Markov microsimulation model (PRISM-CRC), containing socioeconomic quintiles in Victoria, estimated health outcomes in a population aged 50–74 years from 2023–2037. The model simulated the development of CRC, considering the expected population increase in CRC cases projected by the Victorian Cancer Registry (VCR) due to COVID-19 disruptionsand counterfactual scenarios with no disruptions. The model estimated CRC case numbers, CRC deaths, and total costs of CRC screening and treatment by quintile. Screened status, stage of diagnosis, and survival were obtained using a dataset linked to patients diagnosed with CRC in 2009–2021 from the VCR. Results: Post COVID-19, CRC cases and mortality increased across all quintiles, with the greatest impacts in the most disadvantaged groups. Quintile 2 showed the largest relative cancer cases increase (21.7%), followed by quintile 1 (16.3%), whilst quintile 5 increased only 1.2% . CRC deaths rose 30.1% in quintile 1 and 28% in quintile 2, compared to 1.6% in quintile 5. Combined screening, diagnostic testing and treatment costs increased 21.4% in quintiles 1 and 24.8% in quintiles 2, versus 3.4% in quintile 5. Overall, the post-COVID-19 period intensifies the social gradient in CRC incidence, mortality, and healthcare costs. Conclusion: Our study underscores the significant impact ofCOVID-19 disruptions on worsening cancer inequalities. Targeted CRC screening interventions are essential to protect vulnerable populations. Enhanced demographic data from screening programs will help better understand non-participants and groups with low participation rates. 1 | Introduction The impact of the COVID-19 pandemic continues to have lasting impacts on healthcare systems worldwide due to the disruptions to routine medical services [1] . The COVID-19 pandemic led to a substantial disruption to colorectal cancer screening and diagnosis by colonoscopy, and modification of treatment schedulesin many countries [2–5] . Colorectal cancer (CRC) is the world's second-largest cause of cancer death and the third most common malignancy [6] . This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2026 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd. Cancer Medicine, 2026; 15:e71816 1 of 12 [https://doi.org/10.1002/cam4.71816](https://doi.org/10.1002/cam4.71816) The reductions in bowel cancer services and hesitancy in see

FAQs

What question does the study address about COVID-19 and bowel cancer?

It examines the long-term effects of COVID-19-related disruptions on bowel/colorectal cancer health inequalities and healthcare costs in Victoria, Australia.

How is the analysis conducted in the study?

A Markov microsimulation model (PRISM-CRC) simulates CRC development, diagnosis stage, survival, and outcomes across socioeconomic quintiles from 2023–2037, comparing disruption versus no-disruption scenarios.

What were the main findings regarding inequality after COVID-19?

CRC cases and mortality increased across all quintiles, with the largest relative impacts in the most disadvantaged groups; the paper concludes that COVID-era disruption intensifies the social gradient in incidence, mortality, and healthcare costs.

Sep 22, 2026

Upload by Maeve