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Up to half a million endoscopy procedures delayed due to COVID-19

19th March 2021

Research by University College London in partnership with DATA-CAN on the huge backlog in endoscopy services due to the COVID-19 pandemic has been published in the Lancet Gastroenterology and Heptology Journal.

Research by University College London in partnership with DATA-CAN’s scientific lead, Prof Mark Lawler, on the huge backlog in endoscopy services due to the COVID-19 pandemic has been published in the Lancet Gastroenterology and Heptology Journal and also features in the i newspaper.

The study indicated that there is a potential backlog of half a million endoscopic procedures – which are used to diagnose gastrointestinal cancers including bowel (colorectal) cancers, the second most common cause of cancer death.  Worryingly, this backlog is likely to persist for well over a year, even with the mitigation measures being proposed.

The COVID-19 pandemic has had a significant impact on NHS diagnostic services, including endoscopic services. Using routine diagnostic and waiting list data published by NHS England, the research team sought to quantify the national backlog of endoscopic procedures in England and assess how interventions may reduce this backlog.

The researchers found that in April 2020, endoscopic activity fell to 9.5 per cent of the level in April 2019. They estimated that there would be a potential endoscopic backlog of 475,847 procedures which would persist if no additional intervention was considered. This figure could potentially rise to more than 870,000, should there be a further full or partial lockdown and/or a slow return to normality. The adoption of mitigation measures, such as increasing capacity and using tests such as facecal immunochemical testing (FIT) which detects blood in the poo of individuals and therefore can rule out cancer, could still mean that it will take well over a year to eliminate this backlog.

Prof Mark Lawler, Professor of Digital Health, Queen’s University Belfast and Scientific Director DATA-CAN, the UK’s Health Data Research Hub for Cancer said,

“These data provide yet more evidence of the disastrous impact of COVID-19 on cancer services and ultimately cancer patients. The precipitous drop in endoscopic services nationally (to less than 10 per cent of pre-COVID levels) is extremely worrying. We need to address the enormous backlog that has accumulated as a matter of urgency, otherwise we risk significant increases in deaths from colorectal and oesophageal cancer over the next 5 years.”

The number of extra deaths or serious illness caused by delays in endoscopy procedures and diagnosis, was not covered in this study. However several modelling studies have been published in this area.

Professor Lawler added: “In previous work, we have shown that a six month delay could lead to nearly 3,000 excess deaths in people with cancers of the gastrointestinal tract.”