Call for Colonoscopy Wait-time and Performance Guarantee

A parliamentary petition has been launched to rally support for a Colonoscopy Wait-time and Performance Guarantee.

The campaign by Bowel Cancer Australia aims to ensure all Australians with bowel cancer symptoms or a positive FOBT screening test receive a diagnostic colonoscopy within the maximum recommended wait time of 120 days.

Currently, about 90% of National Bowel Cancer Screening Program (NBCSP) participants with a positive result are waiting between 116 and 181 days. One in three wait longer than six months.

Sydney colorectal surgeon Associate Professor Graham Newstead told the limbic the situation was putting people at risk – particularly as the recommended maximum wait time used to be 30 days.

“We’re very lucky in Australia that we have a screening program – it’s not perfect but it’s pretty good – and it’s taken us 25 years or more to get to this point and now they are starting to whittle away at the edges.”

He said while polyps might take five to ten years to turn into a cancer, ‘once you’ve got a cancer they grow very quickly’.

“So if you’ve already got a cancer, you don’t want to be leaving it for months because it will change from a T1N0 to a T1 with a lymph node involved and suddenly you go from a cure rate of 90% down to 40% which means there are people dying because of this delay.”

He said people who were encouraged to participate in a screening program and returned a positive test were being let down if they couldn’t access a timely colonoscopy.

“Some positive FOBTs turn out to be false positives but the vast majority do have something causing their positivity. And having done the test which the government sent them, they then deserve the right to have that looked at.”

He said bottlenecks existed because some public hospitals were trying to save money by limiting the numbers of colonoscopies.

“So you can only book in one half day, in one room, four colonoscopies. That’s obscene when a session that might go from 1 to 6 o’clock should be about a dozen colonoscopies but they will allow you to book four.”

Transparency required to fill the gaps

Bowel Cancer Australia CEO Mr Julien Wiggins said a Colonoscopy Wait-time Guarantee would entail recording and public reporting of wait times then adequate resourcing to fill in the service gaps

“We’re not looking at clinicians reporting in terms of their personal waiting times but certainly at a state or hospital level there needs to be some indication for patients and their GPs at the time of referral as to the expected wait time they could face.”

“Certainly if Hospital X has a wait time of potentially four months which is within guidelines and Hospital Y has a wait time of nine months – well, surely patients should be guided to the ones that will see them more efficiently to reduce the stress, anxiety and the fear of not knowing if they have cancer.”

“There are a number of potential delays in the system and we’re trying to say 120 days has been set as the maximum, NHMRC has endorsed that, governments around the country have endorsed them and they’d better start meeting them.”

Mr Wiggins said the UK had shown wait lists could be turned around – recently reporting that 93% of NHS patients received their colonoscopy within the target wait time of 42 days.

“So it’s not as if it hasn’t been done before; it just that we seem to be dragging our heels on many fronts when it comes to colonoscopy.”

“What is the resourcing necessary to ensure demand can be met? The only way we can work that out is if they start publicly publishing the expected wait times patients are facing so we can get a better picture of where resources need to be allocated.”

“We are going to have 1.11 million colonoscopies in this country by 2021 of which 9% or 100,000 are coming from the NBCSP. So they’ve known about this for quite some time. We’re now asking for a guarantee to ensure that they adhere to their own guidelines,” he said.

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