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Impact of the COVID-19 pandemic on UK endoscopic activity and cancer detection: a National Endoscopy Database Analysis.
Rutter, Matthew D; Brookes, Matthew; Lee, Thomas J; Rogers, Peter; Sharp, Linda.
  • Rutter MD; Gastroenterology, University Hospital of North Tees, Stockton-on-Tees, UK matt.rutter@nhs.net.
  • Brookes M; Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
  • Lee TJ; Department of Gastroenterology, New Cross Hospital, Wolverhampton, UK.
  • Rogers P; Research Institute in Healthcare Science (RIHS), University of Wolverhampton, Wolverhampton, UK.
  • Sharp L; Gastroenterology Research, Northumbria Healthcare NHS Foundation Trust, North Shields, UK.
Gut ; 70(3): 537-543, 2021 03.
Article in English | MEDLINE | ID: covidwho-1066909
ABSTRACT

OBJECTIVE:

The COVID-19 pandemic has had a major global impact on endoscopic services. This reduced capacity, along with public reluctance to undergo endoscopy during the pandemic, might result in excess mortality from delayed cancer diagnosis. Using the UK's National Endoscopy Database (NED), we performed the first national analysis of the impact of the pandemic on endoscopy services and endoscopic cancer diagnosis.

DESIGN:

We developed a NED COVID-19 module incorporating procedure-level data on all endoscopic procedures. Three periods were designated pre-COVID (6 January 2020 to 15 March), transition (16-22 March) and COVID-impacted (23 March-31 May). National, regional and procedure-specific analyses were performed. The average weekly number of cancers, proportion of missing cancers and cancer detection rates were calculated.

RESULTS:

A weekly average of 35 478 endoscopy procedures were performed in the pre-COVID period. Activity in the COVID-impacted period reduced to 12% of pre-COVID levels; at its low point, activity was only 5%, recovering to 20% of pre-COVID activity by study end. Although more selective vetting significantly increased the per-procedure cancer detection rate (pre-COVID 1.91%; COVID-impacted 6.61%; p<0.001), the weekly number of cancers detected decreased by 58%. The proportion of missing cancers ranged from 19% (pancreatobiliary) to 72% (colorectal).

CONCLUSION:

This national 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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Practice Patterns, Physicians&apos; / Endoscopy, Gastrointestinal / Gastrointestinal Neoplasms / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Gut Year: 2021 Document Type: Article Affiliation country: Gutjnl-2020-322179

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Practice Patterns, Physicians&apos; / Endoscopy, Gastrointestinal / Gastrointestinal Neoplasms / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Gut Year: 2021 Document Type: Article Affiliation country: Gutjnl-2020-322179