SURVEILLANCE COLONOSCOPY METRICS HAVE IMPROVED FROM BEFORE THE PANDEMIC

ABSTRACT

Introduction: Since the start of the coronavirus-2019 (COVID-19) pandemic, there has been a decrease in the overall number of elective gastroenterology procedures. We sought to evaluate whether surveillance colonoscopy quality parameters such as polyp detection rate (PDR) and withdrawal times have been affected now that such elective procedures have resumed in greater numbers. Methods: This is a single-center observational study comparing patients who underwent surveillance colonoscopies since our outpatient facilities reopened (7/1/2021 through 9/30/2021) with a pre-pandemic cohort (7/1/2018-9/30/2018). We collected demographic information including patient age, sex, comorbidities, among others. We then tabulated the number of polyps detected, the number of tubular adenomas (TA), and the withdrawal times. We used Chi-square testing to determine significance among our categorical variables and used t-tests to compare means for our numerical variables. All statistical analysis was done in R (R Core Team, 2020). Results: Our pre-pandemic cohort included 195 patients (86 women;44.1%), of whom 81 (41.5%) had a TA on their surveillance colonoscopy. Our 2021 cohort consisted of 308 patients (140 women;45.5%), of whom 149 (48.4%) had a TA on surveillance (Tables 1 and 2). The mean PDR was significantly higher in the 2021 cohort (2.2 vs. 1.5 polyps per colonoscopy;p=0.001), and the mean withdrawal time was likewise longer compared to the pre-pandemic cohort (18.9 minutes vs. 15.8 minutes;p=0.002). While the rate of tubular adenoma detection was similar overall in both groups (41.5% vs. 48.4%;p=0.13), it was higher for male patients in the 2021 group compared to 2018 (55.4% vs. 43.1%;p=0.04). We found no difference in polyp or TA detection based on patient comorbidities, age, sex, race, day of the week, morning versus afternoon endoscopy session, or whether a fellow was involved in the procedure. Conclusion: Despite the 1.5-year hiatus in elective procedures, our quality metrics for surveillance colonoscopies have improved from before the pandemic, and this may be related to longer withdrawal times. We have been able to carry out more surveillance procedures compared to a similar pre-pandemic period irrespective of patient demographic factors, procedure timing, and trainee involvement. We are undertaking further data collection to ensure that our findings are stable over a longer time period. (Table Presented) (Table Presented)