Impact of restrictions due to covid-19 on a quality assured screening colonoscopy program

ABSTRACT

Aims On February 25 , the first patient was diagnosed with COVID-19 in Austria. On March 16 (week 12) Austriangovernment imposed restrictions and subsequently the Austrian Medical Association has recommended to minimizescreening examinations in compliance with government restrictions. Aim Aim was to evaluate the impact of this recommendation on the number of weekly performed colonoscopies, detection of non-advanced adenomas, advanced adenomas (AA) and colorectal cancer (CRC) and to calculate how many undetectedadenomas could develop into CRC. Methods We analyzed number of colonoscopies and pathological findings within a quality assured national colorectal cancerscreening program before the COVID-19 pandemic (January 1 2019 - July 5 2019, Period 1) and compared those ratesto months with limited access to colonoscopy (January 1 2020 and July 5 2020, Period 2) with a two-tailed T-test, aWilcoxon-rank-test and a chi-square test. Results 23.700 colonoscopies were performed in Period 1, and 15.569 in Period 2. The mean rate of colonoscopies perweek in Period 1 was significantly higher than in Period 2 (877,78 [SD=190,44] versus 576,63 [SD=350,58], p = 0,003).4.655 non-advanced adenomas were detected in Period 1 versus 3.221 in Period 2 (p = 0,012). In total 1.863 AAs and 170CRCs were detected in Period 1 versus 1.166 AAs and 91 CRCs in Period 2. These rates did not differ significantly (p = 0,177, and p = 0,131). Conclusions During the COVID-10 the number of performed colonoscopies per endoscopist was significantly lowercompared to the years before but there was no difference in the detection of CRCs and AAs.