COVID-19 disruptions to endoscopic surveillance in Lynch syndrome.

Disruptions in cancer screening due to the COVID-19 pandemic may disproportionally affect patients with inherited cancer predisposition syndromes, including Lynch syndrome. Herein we study the effect of the COVID-19 pandemic on endoscopic surveillance in Lynch syndrome through a prospective study of Lynch syndrome patients at a tertiary referral center who were scheduled for endoscopic surveillance during the COVID-19 pandemic shutdown between 3/16/2020 and 6/4/2020. Of our cohort of 302 individuals with Lynch syndrome, 34 (11%) had endoscopic procedures scheduled during the COVID-19 pandemic shutdown. Of the 27 patients whose endoscopic surveillance was canceled during this period, 85% rescheduled procedures within six months with a median delay of 72 days (IQR 55-84 days), with identification of an advanced adenoma or gastrointestinal cancer in 13%. Individuals who did not have a rescheduled endoscopic procedure were significantly younger than those with a rescheduled procedure (age 35 [IQR 26-43] vs. age 55 [IQR 43-63], p = 0.018). Male sex was also suggestive of increasing likelihood of not having a rescheduled procedure. Taken together, our study demonstrates that the COVID-19 pandemic shutdown led to delayed endoscopic surveillance in Lynch syndrome, with potentially impactful delays among young patients. This data also emphasizes the importance of timely surveillance in Lynch syndrome during this current, as well as potential future, global pandemics.