Cancer cases undiagnosed due to impact of Covid

The findings have been published in the journal Gastroenterology and have been presented at the American Association for Cancer Research conference.

When lockdown restrictions began in March 2020, key cancer services, including diagnostic endoscopy services, were severely impacted as resources across the UK were diverted towards the pandemic response. Surveillance for patients with Barrett’s oesophagus, which in a small fraction of cases can progress to oesophageal cancer, was also suspended.

Dr Richard Turkington, Clinical Senior Lecturer at the Patrick G Johnston Centre for Cancer Research, and lead author on the study, explains: “We investigated how the COVID-19 pandemic has affected the diagnosis of oesophageal and stomach cancer and Barrett’s oesophagus. Analysing data from the Northern Ireland Cancer Registry, we estimated the number of patients who had been diagnosed with these conditions across Northern Ireland between March and September 2020, and compared this with data from 2017-2019.

“We found that diagnoses of oesophageal and stomach cancer fell by 26.6%; meaning that 53 fewer patients than expected were diagnosed during the first six months of the pandemic. For Barrett’s oesophagus diagnoses fell by 59.3% which represents 236 fewer Barrett’s cases than expected.”

Professor Helen Coleman, Deputy Director of the Northern Ireland Cancer Registry and senior author on the study, added: “This study is the first to show the impact of COVID-19 on the pre-cancerous condition, Barrett’s oesophagus. There will be missed opportunities for prevention of cancers due to this sharp decline in Barrett’s oesophagus diagnoses.

“Coupled with the drop in expected numbers of oesophageal and stomach cancer diagnoses, we are very concerned that patients will present later with more advanced disease and have poorer survival outcomes as a result. It is vital that we protect and reinstate our cancer diagnostic services, such as endoscopy, to help minimise the impact of the pandemic on cancer patients.”

Helen Setterfield, Chairperson of OGCancerNI, Northern Ireland’s oesophageal and stomach cancer charity, added: “February 2021 marks Oesophageal Cancer Awareness Month and this timely work highlights the major impact that disruption to endoscopy services has had on early diagnosis of oesophageal and stomach cancer.

“We urge the health service to do all that it can to enable these conditions to be monitored and diagnosed quickly, as early diagnosis saves lives.”

The researchers warn that the pandemic could have a devastating impact with many cases potentially remaining undiagnosed. They highlight the need for individuals with symptoms such as difficulty swallowing, persistent heartburn or unexplained weight loss to seek medical help as soon as possible.

This work was funded by Cancer Research UK, Wellcome Trust, Cancer Focus NI and OGCancer NI and the NICR received funding for this work from Public Health Agency, Northern Ireland.