S1506 Identifying Screening and Diagnostic Endoscopic Delays Due to COVID-19

Introduction: Many healthcare specialties were limited in screening practices and elective procedures during the COVID-19 pandemic. Our institution resumed GI procedures by conducting COVID testing prior to diagnostic and screening procedures. Patients were deferred if positive for COVID. We sought to evaluate the impact of COVID-19 related delays for these procedures. Methods: This retrospective study evaluated outpatient endoscopic procedures delayed due to positive COVID-19 testing from March 2020 to 2022 at an academic center and affiliated community hospital. All patients undergoing endoscopy underwent rapid PCR testing (Abbott ID Now, Chicago, IL) prior to their scheduled procedure. All patients who tested positive were cancelled and informed that they could not reschedule their procedure for 21 days. All cancelled procedures were documented in the electronic medical record using a COVID-19 related cancelation code. Patient and procedural characteristics were identified through a manual chart review. Statistical analysis included t-testing, chi-square, and ANOVA. Results: There were 197 patients eligible for inclusion. The median age was 61 years. Sixty two percent of patients were female, and 72% identified as White. Colonoscopies were the most common delayed procedure (63%), followed by EGD with colonoscopy (19%), and EGD alone (18%). Colorectal cancer screening was the most common indication for colonoscopy (77%), dysphagia for EGD (16%), and symptoms including nausea, abdominal pain, or change in stool habits for EGD and colonoscopy (36%). To date, 46% (N = 91) of delayed endoscopies were completed. There was no significant difference in demographic factors for endoscopy completion (Figure 1). The median time to endoscopy completion was 140 days (IQR 65-320) with no significant difference by type of endoscopy (P = 0.64) or institution (P = 0.48) (Table 1). Conclusion: Endoscopic delays have longstanding implications for cancer screening and diagnosis or treatment of gastrointestinal disease. In this study, more than half of our patients were lost to follow up. The majority who completed endoscopies did so with significant delay. As COVID-19 continues to impact our healthcare system, a commitment to improving the processes of completing diagnostic and screening endoscopies in a timely fashion is essential to improve this gap in patient care.Figure 1.: Patient demographic information for endoscopies that were completed or not completed after delays due to COVID-19. Table 1. - Delay times by procedure and institution. Listed as median (IQR) in days Total (N=91) Academic Center (N=58) Community Hospital (N=33) Total 140 (65-320) 199 (68-294) 166 (54-186) Colonoscopy 152 (70-334) 221 (69-346) 140 (52-135) EGD+Colonoscopy 94 (61-238) 159 (57-203) 181 (65-146) EGD Alone 153 (21-245) 58 (47-251) 250 (78-386)