How to clear a colonoscopy waiting list

When the colonoscopy waiting list at the Royal Adelaide Hospital ballooned to more than 1000 patients, a clinician-led initiative was successful in clearing the backlog within a few months, according to a paper in the Australia and NZ Journal of Surgery.

The turnaround was achieved with a multipronged comprehensive plan drawn up by front-line clinicians and staff, which received financial backing from the State government.

The plan included a revamp of the booking system, flexibility to allow more colonoscopies to be done per session, and on weekends, and a guideline-based audit of the waitlist to identify and prioritise patients who would gain most benefit from colonoscopy.

DAAs the gateway drug to better liver cancer survival

Patients with HCV-related liver cancer who have achieved HCV cure before their cancer diagnosis have improved overall survival compared with patients who are viraemic at diagnosis.

An Australian study of 422 patients with HCV-related hepatocellular carcinoma (HCC) found five-year overall survival was 51% in those who had achieved HCV cure before their cancer diagnosis but only 22% in the viraemic patients. The retrospective study found 24% of patients had a HCV cure – following either interferon-based or DAA treatment – before their cancer diagnosis.

“With widespread use of DAA therapy, it can be expected that higher proportions of patients diagnosed with HCC will have prior HCV cure in coming years,” the study said.

The study found patients with HCV cure before HCC diagnosis were more likely to be detected by surveillance and have earlier tumour stage. However the survival benefit of a HCV cure remained significant in an adjusted analysis.

“If we can encourage patients who present for HCV treatment to remain engaged with the healthcare system and continue HCC surveillance after HCV cure, we can expect further improvements in HCV-related HCC survival in coming years,” the researchers concluded.

The findings are published in the Journal of Viral Hepatitis

IBD patients find symptoms relief with cannabis

More than half of people with IBD would like to try cannabis for relief of their symptoms, according to a New Zealand survey of 378 people with Crohn’s disease or ulcerative colitis.

Overall, 51% of respondents reported having ever used cannabis, of whom 31% used cannabis specifically for reduction of IBD symptoms.

Among cannabis users with IBD, the symptoms most improved by cannabis use were abdominal pain/cramps (96%), loss of appetite (80%) and nausea and vomiting (79%).

Fifty-four percent of participants reported that if cannabis were legal, they would request it for medicinal use to help manage their symptoms, according to the Otago University study published in the NZ Medical Journal.