The SARS-CoV-2 pandemic has brought many challenges that have driven the need to manage patients differently. Amanda Appleton and Emma Isom explain how the increased use of novel diagnostic solutions has helped to address issues in gastroenterology.
The onset of the pandemic caused widespread disruption to many clinical diagnostic pathways. Already overburdened endoscopy services faced considerable reductions, resulting in fewer procedures and, consequently, fewer diagnoses of colorectal cancer (CRC) and significant bowel disease. Colorectal cancer is highly treatable if detected in its early stages,1 and long-term quality of life is much improved following successful treatment. However, the waiting times for endoscopy have resulted, and still are resulting, in concerning delays to diagnosis.2 Therefore, a supporting pathway is a necessary prerequisite to alleviate pressure on the service and prioritise those with the most severe symptoms, for further investigation.
In April 2020, the British Society of Gastroenterology (BSG) published guidance on endoscopy activity during COVID-19. It recommended that all endoscopy, except emergency and essential procedures, should be ceased immediately.3 In the first month of the lockdown period in the UK, endoscopy activity had reduced to only 5% of normal activity.4
Rutter et al. published data from the National Endoscopy Database which showed that ‘pre-COVID’ an average of 394 colorectal cancers were detected by colonoscopy and flexible sigmoidoscopy per week, whereas during COVID this decreased to an average of 112 cases per week.4
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