11 April 2020

During the COVID-19 pandemic, rapid access two week wait colorectal cancer referrals will continue. Changes to our usual methods of managing these patients will have to be made because: 

• Only therapeutic emergency endoscopy is being carried out given the risks of aerosol generating procedures (AGP).
• Colonoscopy, flexible sigmoidoscopy and rigid sigmoidoscopy are currently classified as procedures that may be deferred during the pandemic. The BSG-CAG guidance on endoscopy
• Use of virtual colonoscopy (CT colonography) should also stop unless there is explicit local agreement amongst all relevant stakeholders that capacity exists to continue a reduced service. There will undoubtedly be increased demand for diagnostic and screening CT scanning for patients with confirmed or suspected COVID-19 infection. The British Society of Gastrointestinal and Abdominal Radiology advice
• Hospital footfall increases the risk of contracting COVID-19 infection, with the biggest risk of associated mortality applying to older and/or comorbid patients.
• Many patients with newly diagnosed colorectal cancer may have treatment deferred until healthcare resources recover, unless they develop complications requiring emergency admission

Joint ACPGBI, BSG and BSGAR considerations for adapting the rapid access colorectal cancer pathway during COVID-19 pandemic

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