Impact Of Covid-19 Outbreak On Gastro-Intestinal Cancer Burden

Aims Italy was the first European country to experience COVID-19 outbreak. The aim of this study was to show its impact on the activity of a tertiary care Endoscopy Unit with >18,000 procedures/year.

Methods This is a single-center study performed at Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. Our Institution was converted to COVID-19 Hospital from January to April 2020 and only emergency and oncologic procedures were maintained to preserve both patients’ and operators’ health. Data about outpatients visits and endoscopic examinations performed from January to April 2020 were compared to the same period of 2019.

Results A dramatic drop of all activities was shown. In details, overall outpatient visits decreased of -45,89 % (1100 vs 2033), including -39.5 % (227 vs 375) of IBD and -28.6 % (30 vs 42) biliopancreatic visits. Endoscopic examinations also diminished considerably as shown in table 1. Overall, -64.6 % of gastro-intestinal cancers were detected (17 vs 48). A reduction of -77.8 % and -80 % were obtained in terms of advanced neoplasia (i.e. high-grade dysplasia and villous histology) and adenocarcinomas detected during colonoscopy between the two years (22 vs 100 and 6 vs 30, respectively). Such absolute reduction was not compensated by an increase of relative diagnostic yield, being 8.3 % vs 7.9 % (22/266 vs 100/1256; Odd Ratio [OR] 1.05) and 2.3 % vs 2.4 % (6/266 vs 30/1256; OR 0.94) for advanced neoplasia and colorectal cancer, respectively. Although a reduction of -35.3 %, a significant improvement was showed comparing diagnostic yield of gastric adenocarcinomas, being 2.1 % vs 4.6 % (17/814 vs 11/241; OR 0.44), respectively.

Conclusions COVID-19 caused a notably decrease of all activities, including screening colonoscopy. This produced a reduction of the total amount of neoplasia detected during endoscopy compared to the same period of the previous year. The consequences of this delay are still to be shown.

Tab. 1 Impact of COVID-19 on endoscopic examinations

	2019 March-April	2020 March-April	2020 vs 2019 Total	2020 vs 2019 Total %
Colonoscopy (screening)	1.256 (200)	266 (29)	-990 (-171)	-78,8 % (-85,5 %)
EGD	814	241	-573	-70,4 %
EUS	58	32	-26	-44.8 %
ERCP	45	23	-22	-48.9 %
Total	2.173	562	-1.611	-74,1 %

Citation: Milluzzo SM, Pesatori EV, Hassan C et al. OP87 IMPACT OF COVID-19 OUTBREAK ON GASTRO-INTESTINAL CANCER BURDEN. Endoscopy 2021; 53: S37.

Publication History

Article published online:
19 March 2021