Gastrointestinal cancer pathways may breakdown due to COVID-19

In 2018/2019, 587 517 patients in England were referred on an urgent gastrointestinal (GI) two-week-wait (2WW) cancer pathway.1 Patients attend straight-to-test endoscopy procedures, or urgent clinic appointments. Upper GI cancer pathways have a cancer yield of 3%, lower GI 7%.2 General practitioners (GPs) and hospital clinicians are accustomed to a high volume of referrals with low yield. This has been mutually beneficial, improving GI cancer outcomes for the population, ease of referral in primary care, and generating income for secondary care. Consequently, the majority of patients investigated have benign conditions. These services are pressured due to significant resource and workforce constraints, 90% of patients in 2018/2019 were seen within 14 days (target 93%).1 COVID-19 swept through Europe killing tens of thousands. The peak …