Impact Of Covid-19 Outbreak On Gastro-Intestinal Cancer Burden

Aims Italy was the first European country to experience COVID-19 outbreak. The aim of this study was to show its impacton the activity of a tertiary care Endoscopy Unit with >18,000 procedures/year. Methods This is a single-center study performed at Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. OurInstitution was converted to COVID-19 Hospital from January to April 2020 and only emergency and oncologic procedureswere maintained to preserve both patients' and operators' health. Data about outpatients visits and endoscopicexaminations performed from January to April 2020 were compared to the same period of 2019. Results A dramatic drop of all activities was shown. In details, overall outpatient visits decreased of-45,89 % (1100 vs2033), including-39.5 % (227 vs 375) of IBD and-28.6 % (30 vs 42) biliopancreatic visits. Endoscopic examinations alsodiminished considerably as shown in table 1. Overall,-64.6 % of gastro-intestinal cancers were detected (17 vs 48). Areduction of-77.8 % and-80 % were obtained in terms of advanced neoplasia (i.e. high-grade dysplasia and villoushistology) and adenocarcinomas detected during colonoscopy between the two years (22 vs 100 and 6 vs 30, respectively).Such absolute reduction was not compensated by an increase of relative diagnostic yield, being 8.3 % vs 7.9 % (22/266 vs100/1256;Odd Ratio [OR] 1.05) and 2.3 % vs 2.4 % (6/266 vs 30/1256;OR 0.94) for advanced neoplasia and colorectalcancer, respectively. Although a reduction of-35.3 %, a significant improvement was showed comparing diagnostic yield ofgastric adenocarcinomas, being 2.1 % vs 4.6 % (17/814 vs 11/241;OR 0.44), respectively. Conclusions COVID-19 caused a notably decrease of all activities, including screening colonoscopy. This produced areduction of the total amount of neoplasia detected during endoscopy compared to the same period of the previous year.The consequences of this delay are still to be shown. (Table Presented).