Mr Julien Wiggins, Bowel Cancer Australia

The patient reported experience of colonoscopy is mostly positive although the perennial issue of wait-times hasn’t yet gone away, a survey shows.

About 1,500 Australians who had undergone colonoscopy in the last year completed the online My Colonoscopy Experience questionnaire from Bowel Cancer Australia.

Respondents reported high levels of trust and confidence in their colonoscopist and felt they received clear information about what to expect.

The majority felt they did not experience any physical or emotional harm as a result of their colonoscopy.

However most people (59%) had to wait more than the recommended 30 days from referral before receiving a colonoscopy.

About a third (32%) of respondents waited more than two months and 7% of those people waited more than six months.

Many respondents waiting the longest times for colonoscopy were young but 20% subsequently received a bowel cancer diagnosis.

Two thirds (64%) of respondents received their colonoscopies in private hospitals but it was typically public patients who had to wait the longest.

Some people also had to visit a GP on more than one occasion or insist on a referral for colonoscopy.

Almost a quarter of people (24%) who had to insist on their referral subsequently received a cancer diagnosis.

Bowel Cancer Australia CEO Mr Julien Wiggins told the limbic the questionnaire was a valuable opportunity to get “real feedback from real people” undergoing colonoscopy.

It also provided some indicators of alignment between the patient experience and the Australian Commission on Safety and Quality in Health Care’s(ACSQH) Colonoscopy Clinical Care Standards.

He said wait times were receiving some priority at state and federal levels. It was an agenda item at COAG meetings and money was being directed at the problem.

“We have seen Victoria for example, allocate about $12 million to clear their colonoscopy wait lists. South Australia recently committed $5m to deal with the wait list they have from the National Bowel Cancer Screening Program.”

Direct access to colonoscopy models were also being considered for people with positive screening tests and no other comorbidities that would prevent them from being fast-tracked.

“We know the majority of people are seen in the private sector so it’s not necessarily a workforce issue. It’s more to do with freeing up the resources in the public system and then funding so ideally patients are seen within the 30-day wait time.”

“That’s what the optimal care pathway says. We know delays in accessing colonoscopy can have an adverse impact on outcomes.”

Mr Wiggins said another issue identified through the questionnaire was about choice in bowel prep options.

“We all know that you need a good bowel prep for a good quality colonoscopy,” he said. “The most telling issue from my point of view was the lack of choice people are receiving around the prep.”

“In some instances there was no choice, as opposed to potentially offering what prep options are available, their pros and cons, and then patients can make an informed decision with their specialist or GP as to the most appropriate prep for them.”

He said even apparently minor issues such as bowel prep could be the difference between people with positive screening tests presenting for colonoscopy.

“We need to reduce the barriers where we can and if that is one being identified – that people don’t like taking the prep and it is adversely affecting them – then it certainly needs to be looked at.”