Re-initiation of CT colonography services during the COVID-19 pandemic: Preliminary evaluation of safety

Abstract

Objective: The COVID-19 pandemic has led to cancellation and deferral of many cancer investigations, including CT colonography (CTC). In May 2020, BSGAR and SCoR issued guidelines outlining steps for conduct of CTC in the early recovery phase. We evaluated the implementation of these in four English hospital trusts. Methods: Ethical permission was not required for this multicentre service evaluation. We identified patients undergoing CTC over a 2-month period from May to July 2020 at four Trusts. We recorded demographics, scan indications, colonic findings, and incidental lung base changes compatible with COVID-19. A subset of patients were contacted via telephone to document new symptoms 2 weeks following their scan. Staff were contacted to determine if any acquired COVID-19 during the period. Results: 224 patients (118 male, 52.7%) were scanned during the period. In 55 patients (24.6%), CTC showed a ≥6 mm polyp. 33 of 224 (14.7%) scans showed incidental lung base changes felt unrelated to COVID-19, and only one patient had changes indeterminate for COVID-19; no classic COVID-19 pulmonary changes were found. Of 169 patients with telephone follow-up, none reported any new symptoms of COVID-19 (cough, fever, anosmia, ageusia) within 14 days of CTC. None of the 86 staff contacted developed COVID-19. Conclusion: We found no cases of patients or staff acquiring COVID-19 infection following CTC; and no evidence of significant asymptomatic COVID-19 patients attending for CTC appointments based on lung base changes. Advances in knowledge: Our findings suggest that current practice is unlikely to contribute significantly to spread of SARS-nCOV2. Cancer and significant polyp detection rates were high, underlining the importance of maintaining service provision.

Colorectal Cancer Screening: Impact of COVID-19 Pandemic and Possible Consequences

“…CTC is a faster procedure compared to colonoscopy and lends itself to social distancing, given that the process involves a computed tomography (CT) scan where no patient-staff physical contact is necessary. The study was done safely as no patients or staff involved in the CTCs were found to have COVID-19 after the test [37]. Additionally, CCE involves minimal physical contact between patients and staff; in fact, only one medical provider is needed to administer the test to a patient that can also be done remotely [38].…”