Resumption of endoscopy in the Galician colorectal cancer screening programme after the COVID-19 lock down: patient safety results

Peña-Rey, I.; Almazán, Raquel; Rodríguez-Camacho, Elena; Cubiella, Joaquín

doi:10.17235/reed.2020.7647/2020

Cited by 7 publications

(9 citation statements)

References 9 publications

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“…Four studies, 1 from the United Kingdom, 1 from Spain, and 2 from the United States (Veterans Affairs Healthcare System and Tri-NetX database) reported on endoscopy volumes in the late stages of the pandemic. 20,41,47,50 The reported endoscopy utilization was between 40% and 70% in the United States, between 40% and 100% in Europe, and approximately 70% of expected volumes in the Veterans Affairs study. A modeling study from Canada estimated that it will take 41 months to complete all of the backlog of colonoscopies.…”

Section: Summary Of the Evidencementioning

confidence: 98%

“…We found 8 studies (2 prospective and 6 retrospective cohort studies) that reported rates of infection among HCWs and patients undergoing endoscopy. 10,14,15,[20][21][22][23][24] Of these studies, 5 were in the context of a preprocedure testing strategy, 10,14,15,21,23 and 3 did not have an explicit preprocedure testing strategy. 20,22,24 Among patients who underwent endoscopy, the rates of infection ranged from 0% to 0.4%.…”

Section: Summary Of the Evidencementioning

confidence: 99%

“…10,14,15,[20][21][22][23][24] Of these studies, 5 were in the context of a preprocedure testing strategy, 10,14,15,21,23 and 3 did not have an explicit preprocedure testing strategy. 20,22,24 Among patients who underwent endoscopy, the rates of infection ranged from 0% to 0.4%. Among HCWs, the rates of infection ranged from 0% to 4.0%.…”

Section: Summary Of the Evidencementioning

confidence: 99%

“…Fourteen studies (1 survey study and 13 cohort studies, mostly based on administrative datasets) reported on endoscopy volumes from the United States, United Kingdom, The Netherlands, Canada, China, Spain, Japan, and Taiwan during the initial 3-4 months of the pandemic. 20,21,37,[40][41][42][43][44][45][46][47][48][49][50] Four studies report on the later period of the pandemic. Across studies, in the early phases of the pandemic, the total number of upper endoscopies and colonoscopies decreased by 51%-72% and 59%-85%, respectively.…”

Section: Summary Of the Evidencementioning

confidence: 99%

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AGA Rapid Review and Guideline for SARS-CoV2 Testing and Endoscopy Post-Vaccination: 2021 Update

et al. 2021

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This guideline provides updated recommendations on the role of pre-procedure testing for SARS-CoV2 in individuals undergoing endoscopy in the post-vaccination period and replaces the prior guideline from the American Gastroenterological Association (released July 29, 2020). Since the start of the pandemic, our increased understanding of transmission has facilitated the implementation of practices to promote patient and healthcare worker (HCW) safety. Simultaneously, there has been increasing recognition of the potential harm associated with delays in patient care as well as inefficiency of endoscopy units. With widespread vaccination of HCWs and the general population, a re-evaluation of AGA’s prior recommendations was warranted. In order to update the role of pre-procedure testing for SARS-CoV2, the AGA guideline panel reviewed the evidence on (1) prevalence of asymptomatic SARS-CoV2 infections in individuals undergoing endoscopy, (2) patient and HCW risk of infections that may be acquired immediately before, during, or after endoscopy, (3) effectiveness of COVID-19 vaccine in reducing risk of infections and transmission, (4) patient and HCW anxiety, (5) patient delays in care and potential impact on cancer burden, and (6) endoscopy volumes. The panel considered the certainty of the evidence, weighed the benefits and harms of routine pre-procedure testing, and considered burden, equity, and cost using the GRADE framework. Based on very low certainty evidence, the panel made a conditional recommendation against routine pre-procedure testing for SARS-CoV2 in patients scheduled to undergo endoscopy. The panel placed a high value on minimizing additional delays in patient care, acknowledging the reduced endoscopy volumes, downstream impact on delayed cancer diagnoses and burden of testing on patients.

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Section: Summary Of the Evidencementioning

confidence: 98%

Section: Summary Of the Evidencementioning

confidence: 99%

Section: Summary Of the Evidencementioning

confidence: 99%

Section: Summary Of the Evidencementioning

confidence: 99%

See 2 more Smart Citations

AGA Rapid Review and Guideline for SARS-CoV2 Testing and Endoscopy Post-Vaccination: 2021 Update

et al. 2021

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“… 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 One of the main reasons for this reduction was that most CRC screening programmes were cancelled during the pandemic lockdown. 19 , 20 , 21 Moreover, endoscopy services also reduced their activity and fewer colonoscopies were performed during this time to diagnose patients with suspected CRC. 22 , 23 …”

Section: Introductionmentioning

confidence: 99%

Has the COVID-19 pandemic changed the clinical picture and tumour stage at the time of presentation of patients with colorectal cancer? A retrospective cohort study

Cano-Valderrama¹,

Sánchez-Santos²,

Vigorita³

et al. 2023

Cirugía Española (English Edition)

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Safety of Endoscopy Units during the COVID-19 Pandemic

Gonçalves¹,

Guimarães²,

Carvalho³

et al. 2022

GE Port J Gastroenterol

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Introduction: The COVID-19 pandemic drastically changed the daily routine of all healthcare systems worldwide, and endoscopy units were no exception. Endoscopic exams were considered to have a high risk of transmission, and therefore, the safety of endoscopy units and the consequent need for pre-endoscopy SARS-CoV-2 screening were questioned early on. The aim of our study was to assess the safety of endoscopy units during the COVID-19 pandemic, as well as the effectiveness/necessity for SARS-CoV-2 screening prior to endoscopies. Material and Methods: This is a retrospective and single-center study carried out in a Portuguese tertiary hospital. All patients who underwent endoscopic procedures between September 1, 2020 and February 28, 2021 were included. The pre-endoscopy screening consisted of a specific questionnaire or a RT-PCR test for SARS-CoV-2 (nasal and oropharyngeal swab). Data were obtained through patient’s clinical records and the Trace COVID platform. Results: A total of 2,166 patients were included. Patients had a mean age of 61.8 years and were predominantly male (56.2%, n = 1,218). Eighty-one (3.7%) patients had previous SARS-CoV-2 infection, with a median difference of 74 days (IQ 40.5:160.5) between infection and endoscopy. Most patients (70.2%, n = 1,521) underwent PCR screening for SARS-CoV-2 up to 72 h before the procedure, with the remaining patients (29.8%, n = 645) answering a questionnaire of symptoms and risk contacts up to 3 days before endoscopy. Of the patients who underwent RT-PCR screening for SARS-CoV-2, 21 (1.4%) tested positive, and all were asymptomatic at the time of the screening. The evaluation for SARS-CoV-2 infection up to 14 days after the endoscopic exams identified 9 positive patients (0.42%) for SARS-CoV-2. The median difference in days between endoscopy and the diagnosis of infection was 10 days. Discussion/Conclusion: Pre-endoscopy screening with RT-PCR test for SARS-CoV-2 identified a very small number of patients with COVID-19 infection as well as patients with COVID-19 infection in the following 14 days. Therefore, the risk of infection in endoscopy units is negligible if screening of symptoms and risk contacts is applied and individual protective equipment is used.

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Resumption of endoscopy in the Galician colorectal cancer screening programme after the COVID-19 lock down: patient safety results

Cited by 7 publications

References 9 publications

AGA Rapid Review and Guideline for SARS-CoV2 Testing and Endoscopy Post-Vaccination: 2021 Update

AGA Rapid Review and Guideline for SARS-CoV2 Testing and Endoscopy Post-Vaccination: 2021 Update

Has the COVID-19 pandemic changed the clinical picture and tumour stage at the time of presentation of patients with colorectal cancer? A retrospective cohort study

Safety of Endoscopy Units during the COVID-19 Pandemic

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