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Minimal risk of catching COVID-19 as a result of endoscopy

28/10/2020

More than 6,000 patients who underwent endoscopy at 18 NHS hospitals since the start of pandemic have been tested and none contracted COVID as a result of the procedure, a study involving clinicians from Oxford University Hospitals (OUH) NHS Foundation Trust has found.

Clinicians hope the findings will persuade people that it is safe to attend their endoscopy appointments, which can be crucial in detecting cancer at an early stage. Detecting and treating cancer early is a key part of ongoing successful treatment.

The findings coincide with a national campaign reminding people that safe cancer care is still available. A recent survey showed that nearly half the public would delay or not seek medical help at all, with 22 per cent not wanting to burden the health service, and a similar number saying that fear of getting COVID-19 or passing it onto others was a major reason for not getting help.

The study, published in the international gastroenterology and hepatology journal, Gut, was conducted in 18 UK healthcare centres, which included tertiary and local settings serving a broad range of populations.

Data were collected from 6,208 patients undergoing endoscopy at the 18 centres between 30 April and 30 June 2020. Follow-up data on symptoms showed that there were no cases of COVID-19 detected - in the patients or staff - in the two weeks following the procedure.

The study was supported by the NIHR Oxford Biomedical Research Centre.

When endoscopy procedures resumed in April 2020, services were substantially reduced in part as a result of the significant safety measures that have had to be put in place to minimise the risk of COVID-19 and protect patients from infection. However, another major factor has been the reluctance of patients to attend for investigations; many services have reported a large number of patients are not attending appointments.

Professor James East, OUH's Clinical Lead for Endoscopy and an author on the study, said: "Our findings show that the infection control measures that have been put in place across the NHS work, and should be continued in outpatient diagnostics in the COVID-19 recovery phase.

"We hope this reassures patients who are anxious about attending hospital. COVID-19 is a risk that we have taken significant steps to mitigate, and we must also address the risk of harm from delayed or missed diagnoses because people are reluctant to attend appointments in hospital.

"We'd like to remind people receiving cancer care in Oxfordshire that safe cancer care is available to them during the COVID-19 pandemic. Our Trust has taken numerous measures to make sure our patients can still receive their care in a safe environment. These include designating the Churchill Hospital as a 'cold' site, which means that the presence of COVID-19 is brought down to an absolute minimum."

Delayed presentation, and temporary suspension of screening and diagnostic services, are estimated to have resulted in 2,700 fewer patients being diagnosed with cancer in the UK each week.

One study used cancer registry and admissions data to model the impact of COVID-19 delays on additional cancer deaths among four major cancers (breast, lung, colorectal and oesophageal). This estimated more than 3,000 additional avoidable cancer deaths in the next five years in the UK, with an increase of over 15 percent colorectal cancer deaths and up to six percent oesophageal cancer deaths.