The coronavirus disease 2019 (COVID-19) pandemic has been causally linked to a decline in endoscopic services. This disruption of endoscopic activity has been associated with a decline in the number of diagnoses of Barrett esophagus and esophagogastric cancer, according to the results of a study published in Gastroenterology.
A team of investigators in Belfast, Northern Ireland, conducted a study to determine the effect of the COVID-19 pandemic on the pathologic diagnosis of Barrett esophagus and esophagogastric cancer within population-based databases in Northern Ireland.
The Northern Ireland Cancer Registry (NICR) used electronic pathology reports to identify all unique patients diagnosed with histopathologically confirmed esophagogastric cancer (corresponding to International Classification of Disease version 10 [ICD-10] codes C15 and C16), or Barrett esophagus (corresponding to SNOMED location codes T56010 or T56000 in combination with morphology codes D530910 or M73320), from March 1, 2020, to September 12, 2020 (weeks 10-37).
A comparison was made between these data and the 3-year average number of histopathologically confirmed instances of esophagogastric cancer during the same period from 2017 to 2019.
The researchers found that the number of esophagogastric cancer diagnoses declined by 26.6% between March and September 2020 compared with the equivalent time frame in the years 2017 to 2019. In addition, a 59.3% decline in the number of Barrett esophagus diagnoses was reported between March and September 2020 compared with the equivalent time frame during the years 2017 to 2019. In April 2020 alone, the researchers identified a 95.5% decline in the number of Barrett esophagus diagnoses compared with previous years.
This study was limited by the Northern Ireland Barrett’s Registry (NIBR) likely underestimating the total number of Barrett esophagus cases because the detailed data extraction undertaken was not feasible for rapid Barrett esophagus case reporting.
These findings highlight the need for prioritizing the timely diagnosis of cancer and premalignant conditions even during the COVID-19 pandemic.
Turkington RC, Lavery A, Donnelly D, Cairnduff V, McManus DT, Coleman HG. The impact of the COVID-19 pandemic on Barrett’s esophagus and esophago-gastric cancer. Gastroenterology. Published online January 21, 2021. doi:10.1053/j.gastro.2021.01.208