COVID-19: 1st wave significantly reduced GI neoplasia detection
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A typically high-volume endoscopy unit in Italy saw a significant reduction in procedures in the early stages of the COVID-19 pandemic, according to research presented at ESGE Days.
Sebastian M. Milluzzo, MD, from Fondazione Poliambulanza Istituto Ospedaliero in Brescia, Italy, said that since Italy was the first European country to experience a COVID-19 outbreak, hospitals there were seriously impacted in early 2020.
“Our institution — Poliambulanza, which is located in Brescia in the Northern part of Italy near Milan — was converted to a COVID-19 hospital from March to April 2020,” he said. “Only emergency and oncologic procedures were performed.”
Researchers compared data from a single center about outpatient visit and endoscopic examinations completed between January and April 2020 with the same time period 1 year prior.
Milluzzo and colleagues found that overall outpatient visits decreased by more than 45% from 2019 to 2020 (2,033 vs. 1,100). That included a nearly 40%-drop in visits for inflammatory bowel disease and a 28% reduction in biliopancreatic visits.
Looking at just March and April 2020, researchers determined that just 562 endoscopic procedures were completed (74.1% reduction from 2019), including 266 colonoscopies (78.8% reduction), 241 EGDs (70.4% reduction), 32 endoscopic ultrasounds (44.8% reduction) and 23 endoscopic retrograde cholangiopancreatographies (48.9% reduction).
Due to this reduction in case volume, Milluzzo and colleagues also found that the center had a significant reduction in neoplasia yield. In 2019, 48 GI cancers were diagnosed at the center compared with just 17 in 2020 (64.6% reduction). Advanced adenomas detected went from 100 to 22 (77.8% reduction), while colorectal cancers detected went from 30 to 6 (80% reduction) and gastric cancers went from 17 to 11 (35.3%).
“COVID-19 decreased all of the activities of our endoscopy unit, including colorectal cancer screening colonoscopy,” Milluzzo said. “This produced a reduction in the total amount of neoplasia detected compared to 2019. The consequences of this delay are still to be shown.”
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