Objective The COVID-19 pandemic has placed an inexorable strain on endoscopy services worldwide, affecting the diagnosis of esophago-gastric (EG) cancer and Barrett’s esophagus (BE). As coronavirus infection rates rose many professional bodies advised that all endoscopy, except emergency and essential procedures, be stopped immediately. We sought to quantify the decline in EG cancer and BE diagnoses following implementation of British Society of Gastroenterology (BSG) guidance related to COVID-19 and the psychosocial effects on BE patients. Methods We examined EG cancer and BE diagnoses in Northern Ireland from March-September 2020 and compared them with the three-year average number of patients during the same time period between 2017-2019 by utilizing Northern Ireland Cancer Registry (NICR) data. The psychosocial impact of COVID-19 was assessed using an online survey, which included validated WHOQOL-BREF and EQ-5D-5L quality of life measures, and was completed by 24 BE patients from April-May 2020. Results During the first six months of the pandemic the proportion of EG cancer and BE diagnoses declined by 26.6% and 59.3%, respectively, compared to expected levels. In April, BE diagnoses fell by 95.5% but by September, whilst EG cancer rates had returned to baseline, BE cases remained suppressed by approximately 20%. We estimate that these declines in diagnosis represent 53 ‘missed’ EG cancer and 236 ‘missed’ BE diagnoses. In the online survey sample, BE patients reported consistently lower quality of life scores than population norms, and highlighted a number of concerns with regard to their health and care. Conclusion The COVID-19 pandemic has resulted in an abrupt decline in EG cancer and BE diagnoses and has profoundly impacted the wellbeing of BE patients. Our study represents the first report of the impact of COVID-19 on the diagnosis of BE. Strategies to mitigate the ongoing effects of the pandemic are urgently required to preserve the ability to rapidly detect and diagnose cancer and pre-malignant conditions.

Citation Format: Richard C. Turkington, Anita Lavery, David Donnelly, Anna T. Gavin, Damian T. McManus, Victoria Cairnduff, Charlene M. McShane, Brian T. Johnston, Lesley A. Anderson, Helen G. Coleman. The impact of the COVID-19 pandemic on Barrett’s esophagus and esophago-gastric cancer [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2021 Feb 3-5. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(6_Suppl):Abstract nr S02-03.