COVID-19 recovery: tackling the 2-week wait colorectal pathway backlog by optimising CT colonography utilisation

Abstract

AIM To review the indications for computed tomography colonography (CTC) performed on patients referred via the 2-week wait colorectal pathway (2WWCP). MATERIALS AND METHODS A retrospective study was performed on all patients referred through the 2WWCP between October 2018 and September 2019. The referrals were audited against the National Institute for Health and Care Excellence (NICE) NG12/DG30 guidelines for referral to the 2WWCP, and against the Royal College of Radiologists (RCR) 2017 guidelines for CTC. RESULTS Over the study period, there were 1,707 2WWCP referrals, and 362 (21.2%) of these patients underwent CTC. The median age was 66 years, and 55% were female. Forty-six patients did not meet the NICE NG12/DG30 guidelines for referral to the 2WWCP, and a further 268, although meeting the NICE guidelines, did not meet the RCR 2017 guidelines for CTC. In total, only 13% of CTCs performed complied with both guidelines. CONCLUSION This audit demonstrated a significant opportunity to reallocate CTC resources in the recovery stage of the COVID-19 pandemic. To improve outcomes for colorectal cancer (CRC) in the UK, establishing a selective straight-to-test CTC 2WWCP should be considered. Documented consent detailing the risks and benefits of CTC versus colonoscopy should take place in order to assist the patient in making an informed choice.

Colon capsule endoscopy in patients with chronic respiratory disease during the COVID‐19 pandemic

“…Histopathological examination by therapeutic endoscopy using CS with personal protective equipment revealed six cases of adenoma, six cases of hyperplasia, one case of carcinoma in situ and no advanced cancer. There were no adverse events, such as retention, in any patient and no evidence of SARS-Cov-2 infection in There is a report suggesting the possibility of colon CT examination[3] and positron emission tomography[4] as an alternative method during the COVID-19 pandemic. However, CCE is free from radiation exposure and the only examination that can be performed at home without coming to hospital during the pandemic.…”

“…There were no adverse events, such as retention, in any patient and no evidence of SARS‐Cov‐2 infection in healthcare professionals. There is a report suggesting the possibility of colon CT examination [3] and positron emission tomography [4] as an alternative method during the COVID‐19 pandemic. However, CCE is free from radiation exposure and the only examination that can be performed at home without coming to hospital during the pandemic.…”