A huge number of non-emergency appointments over the past year have been cancelled or postponed due to Covid-19. Many of these appointments were carried out remotely, such as via telephone, meaning that any physical examinations could not take place.

Clinicians across Europe have now revealed that they are seriously concerned about the effects this could have on cancer patients.

A recent survey by SERMO found that 74% of clinicians are concerned that there is likely to be a ‘ticking timebomb’ of cancer patients waiting for diagnosis and treatment, as a result of Covid-19.

Endoscopists are particularly concerned, since endoscopy services have been considerably affected by the pandemic.

Endoscopy services have been considerably affected by the pandemic 

The survey revealed that 79% of clinicians believe Covid-19 has significantly increased waiting times in endoscopy, while 60% reported that over a quarter of endoscopies have been cancelled in their hospital or clinic during the last 6 months.

Data from the National Endoscopy Database indicates that, in the UK, total endoscopic activity fell to 5% of normal levels during the peak of the Covid-19 epidemic in April 2020.

Furthermore, 76% of participants said that endoscopies are now taking longer due to the extra infection prevention measures put in place.

These delays and cancellations are thought to have severe consequences for cancer patients. This is because many patients will now have more progressed cancers which are harder to treat.

The majority (56%) of endoscopists surveyed said they are also concerned about Covid-19 transmission during an endoscopy procedure.

In an effort to try and protect healthcare professionals who are carrying out such procedures, Fujifilm has launched a transnasal endoscope and a droplet shielding mouthpiece.

Transnasal endoscopes can significantly lower the risk of transmission for healthcare professionals 

While the transnasal endoscope reduces the levels of gagging in patients, the PPE mouthpiece reduces the risk of droplets coming into contact with the endoscopist. The equipment therefore not only helps to enhance efficiencies, but also significantly lowers the risk of transmission for healthcare professionals.

As part of the survey, the participants were asked what technological developments they would like to see to make their life easier, as a result of the pandemic. 81% of those polled said they would benefit from innovative PPE accessories that protect both the clinician and the patient while performing endoscopy.

Additionally, 82% said they would benefit from rapid testing of patients for COVID-19 before an endoscopy and 41% reported they would benefit from clinically approved trans-nasal endoscopy as an alternative to oral endoscopy.

Dr Edward J Despott, Clinical Lead of Endoscopy Services at the Royal Free Hospital in London is leading a session at ESGE Days 2021 on the benefits of transnasal endoscopy. He said:

“I am particularly concerned by the postponement and cancellation of non-urgent care and the impact this is having on patients. This is clearly reflected by my peers across Europe in the survey. It is crucial to get endoscopies up and running again for the benefit of patients, but this has to be achieved in a safe way. Using transnasal endoscopy is one of the potential solutions. It is much more comfortable and tolerable for patients, enhances the turnaround for procedures and increases efficiency. Indeed, transnasal endoscopes do not require sedation and therefore reduce the need for dedicated recovery areas. In addition, it offers endoscopists the ability to operate with good levels of safety and protection from COVID-19, reducing the risk of virus transmission by limiting aerosol spread."

He continued: “While some clinicians believe transnasal endoscopy systems are inferior to oral endoscopes, research shows that this is simply not true. The transnasal approach reduces the risks for the patient to gag and therefore offers endoscopists the potential to operate with greater levels of safety and protection from COVID-19, reducing the risk of virus transmission by limiting aerosol spread. As transnasal endoscopy does not require sedation, it also reduces patient-to-patient and patient-to-staff contacts, thus limiting the risks for clinicians and patients to contract virus. All without compromising on quality.”