Study Warns of Endoscopy Tsunami and Missed Cancers

Dawn O'Shea

August 03, 2020

Major concerted and coordinated national, regional, and local efforts are required to restore endoscopy capacity to prevent an impending cancer healthcare crisis, say the authors of a paper published in Gut.

The study used the National Endoscopy Database (NED) to perform the first national analysis of the impact of the pandemic on endoscopy services and endoscopic cancer diagnosis. Three periods were designated: pre-COVID (6 January to 15 March), transition (16 to 22 March), and COVID-impacted (23 March to 31 May).

In the pre-COVID period, an average of 35,478 endoscopy procedures were performed per week. Activity in the COVID-impacted period reduced to 12% of pre-COVID levels. At its low point, activity was only 5% of pre-COVID levels, recovering to 20% by the end of the study.

More selective vetting increased the per-procedure cancer detection rate from 1.19% pre-COVID to 6.61% in the COVID-impacted period (P<0.001). However, the number of cancers detected weekly decreased by 58%. The proportion of missing cancers ranged from 19% (pancreatobiliary) to 72% (colorectal).

This analysis demonstrates the remarkable impact that the pandemic has had on endoscopic services, which has resulted in a substantial and concerning reduction in cancer detection.

Major, urgent efforts are required to restore endoscopy capacity to prevent an impending cancer healthcare crisis, the authors conclude.

Rutter MD, Brookes M, Lee TJ, Rogers P, Sharp L. Impact of the COVID-19 pandemic on UK endoscopic activity and cancer detection: a National Endoscopy Database Analysis. Gut. 2020 Jul 20 [Epub ahead of print]. doi: 10.1136/gutjnl-2020-322179. PMID: 32690602 Full text.

This article originally appeared on Univadis, part of the Medscape Professional Network.

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