{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T18:12:32Z","timestamp":1788286352453,"version":"build-2803163510"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA265020"],"award-info":[{"award-number":["R01CA265020"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["T32CA272303"],"award-info":[{"award-number":["T32CA272303"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The COVID-19 pandemic caused reductions in cancer screening services. We assessed the pandemic\u2019s impact on colorectal cancer screening in a large diverse federally qualified health center (FQHC) in Los Angeles, CA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used interrupted time series regression to estimate trends in monthly colorectal cancer screening rates for four relevant COVID-19 pandemic periods: pre-pandemic (March 2018 \u2013 February 2020); early-pandemic (March \u2013 December 2020); vaccine-era (January 2021\u2013 May 2023); and post-pandemic (June 2023 \u2013 May 2024). We plotted spatial distribution patterns of screening across census tracts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants were 83,430 unique individuals (55% male; 80% Hispanic) ages 50\u201375. Average monthly colorectal cancer screening rates dropped from 9.3% pre-pandemic to 5.9% early-pandemic. Monthly screening rates in the vaccine era (7.5%) never returned to pre-pandemic levels and further declined in the post-pandemic era (6.7%; p trend\u2009=\u20090.09). Screening rates were consistently higher for males, ages 65\u201375, Hispanic individuals, and Spanish-preferring individuals in both pre-COVID (March 2018-Feb 2020) and post-COVID (July 2020-May 2024) periods. Increases in stool-based testing aligned with mailed outreach campaigns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Monthly post-pandemic screening rates never reached pre-pandemic levels and declined from 2023 to 2024. Sharp increases in stool-based testing coincided with mailed outreach events, highlighting the importance of home-based screening methods during disruptive events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>Our findings can help shape healthcare response strategies to reduce screening delays in the context of future natural disasters.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0345248","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T17:40:21Z","timestamp":1774374021000},"page":"e0345248","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Temporal and geographic analyses of colorectal cancer screening during and after the COVID-19 pandemic in a federally qualified health 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