Experts admit that the postponement in a large number of endoscopies and colonoscopies, as a result of the COVID-19 pandemic, may impair the screening and surveillance of some of the most frequent cancers in the Portuguese population.

This possibility is recognized by Mário Dinis-Ribeiro, professor at the Faculty of Medicine of the University of Porto and a researcher at CINTESIS, in an article published in the Nature Reviews – Gastroenterology & Hepatology.

According to the researcher, “COVID-19 is affecting gastrointestinal endoscopy, both in terms of diagnosis and therapy, and will continue to affect it in the future”. The solution is to adapt daily practices, performing a screening and risk stratification in all patients who need endoscopy and even postponing procedures considered non-urgent.

The objective is to protect health professionals, who are especially exposed to infection, especially in the face of a shortage of personal protective equipment (PPE), and patients, especially those at higher risk, such as those suffering from heart disease, lung disease, cancer and those with compromised immune systems.

“Doctors must carefully weigh, on a case-by-case basis, the benefits of endoscopy and the risk of infection with the new coronavirus (SARS-CoV-2). This can have a significant impact on cancers diagnosed and treated with endoscopy, such as gastric cancer and colorectal cancer ”, says the specialist, who currently serves as chair of the Sociedade Europeia de Endoscopia Gastrointestinal.

In addition to patients who have seen their endoscopies and colonoscopies postponed, there are many patients who canceled their exams or did not show up for fear of being infected with the new coronavirus, as well as professionals from the units who were assigned to other services or who were in isolation or quarantine. because of COVID-19.

Overall, Mário Dinis Ribeiro admits that the lack of screening for these cancers can affect millions of people around the world and that the short-term effects are still unknown. One of the biggest fears is that many cancers will go undetected in the early stages, which will have a substantial impact on the treatment and survival of patients.

It is hoped that diagnostic and surveillance tests can be rescheduled “as soon as possible”. However, there are still many open questions, such as, for example, the prioritization of patients for endoscopy, while the pandemic lasts.

In Portugal, the Directorate-General for Health issued a regulation emphasizing the high risk of these procedures, due to the “proximity to the airways, contact with contaminated secretions and generation of aerosols,” and recommends specific measures to be taken by patients and professionals in the reorganization of these services, in order to reduce the risk of transmission of SARS-CoV-2 and to control the spread of COVID-19.