COVID-19 and its impact on endoscopy services: what is the threshold for missed malignant diagnosis?
Tony He, Michael MacIsaac, Simon J. Hume, Alexander Thompson, Julien D. Schulberg
Abstract
We read the study by Rutter et al 1 with interest. The substantial decrease in the cancer detection rate in the UK as a consequence of a reduction in endoscopy activity during the COVID-19 era is alarming. Early in the lockdown, UK endoscopy activity dropped to as low as 5% of pre-COVID levels, with activity only increasing to 20% after 10 weeks. More selective screening did significantly increase the per-procedure cancer detection rate (pre-COVID 1.91%; COVID-19 impacted 6.61%; p<0.001); however, despite this, endoscopic cancer detection reduced by 58% overall, with a concerning 72% detection reduction for colorectal cancer. Similarly, in the USA, a recent report found a 50% reduction in colorectal diagnosis as a result of the pandemic.2 COVID-19 remains an ongoing worldwide pandemic. Gastrointestinal (GI) endoscopy is considered an aerosol-generating procedure for SARS-CoV-2 transmission.3 There remain limited data to provide insight into creating a safe model for rationing …