Management strategies for the colonoscopic surveillance of people with Lynch syndrome during the COVID-19 pandemic.

The recent publication of UK guidelines for the management of hereditary colorectal cancer1 immediately preceded the COVID-19 pandemic. We commend the response by the British Society of Gastroenterology (BSG) relating to GI endoscopy activity amidst this pandemic.2 Such urgent measures are required to curtail the rate and breadth of coronavirus transmission throughout the country, and we are of the belief that the adherence to these guidelines during the early stages of this global pandemic was crucial in saving lives, and further guidance relating to the ‘recovery’ phase will be crucial in delivering diagnostic and cancer preventing endoscopic interventions. Though the emergency endoscopy COVID-19 guidance expressed clear and justified recommendations for the suspension of these services in non-urgent or routine screening populations, the management of patients deemed as being ‘high risk’ and subsequently prioritised for colonoscopy during this time is not currently well defined. For example, specific guidance for surveillance of individuals with conditions such as Lynch syndrome appeared vague in some statements …