Unacceptable delays for colonoscopies

Bowel Cancer Australia is calling on Federal, State and Territory Governments to commit to a national Colonoscopy Wait-time Guarantee to address delays in diagnosing Australia’s second biggest cancer killer.


“It is unacceptable that people with a positive screen or bowel cancer symptoms have to wait six months or longer for a colonoscopy to learn if they have cancer,” said Bowel Cancer Australia Chief Executive, Julien Wiggins.


Research shows diagnostic intervals exceeding 120 days are associated with poorer outcomes, yet 90% of National Bowel Cancer Screening Program (NBCSP) participants with a positive screen are waiting between 116-181 days.


“During a colonoscopy, pre-cancerous polyps can be detected and removed before they develop into something more sinister requiring surgery and treatment,” said colorectal surgeon, Graham Newstead.


“If bowel cancer is detected, and it is still in the earliest stages, 90 percent of cases can be successfully treated,” he added.


“Research reveals people who do not receive a colonoscopy within six months of a positive screen are unlikely to in the future – not without further intervention,” Dr Newstead said.


Bowel Cancer Australia has long advocated for referral to colonoscopy within 30 days to minimise patient stress and anxiety, as recommended in the Optimal Care Pathway for people with bowel cancer.


Newly released medical guidelines, however are now recommending patients be referred to colonoscopy within a maximum 120-day threshold.


“Despite extending the recommended timeline-to-diagnosis by 300%, the new timeframes are still not being met,” said Mr Wiggins, who shares concerns expressed by individuals involved in developing the new guidelines, that the extended threshold de-emphasises the need for prompt evaluation.

“What is needed is a Colonoscopy Wait-time Guarantee,” said Mr Wiggins, “complete with public wait time recording, reporting and adequate resourcing of colonoscopy.”


“Publishing wait times will highlight where resources need to be allocated to improve patient care and will demonstrate a clear commitment on the part of government to meet their own endorsed colonoscopy wait-time recommendations,” said Mr Wiggins.


In the UK, the NHS Constitution pledges a six week (42 day) wait time for diagnostic tests. As of December 2017, 92.7% of patients received a colonoscopy within the targeted 42 days or less from time of referral.


In contrast, only 4-in-10 (40%) participants in the Australian national screening program received a colonoscopy within 60 days.


“People who receive a positive screen or experiencing bowel cancer symptoms need assurance that they will receive a necessary diagnostic colonoscopy within recommended guidelines,” Mr Wiggins said.


Kristy Welch agrees; she had to wait months before receiving a colonoscopy, despite experiencing severe symptoms for over a year.


“I was spending a lot of my work day in the bathroom,” Ms Welch said.


“The main symptoms were blood clots every few months and I was getting really worried.”


“I was in the bathroom around 25 times a day by the time I received my colonoscopy,” Ms Welch said.


“I was sent directly to hospital and three days later they removed 16.5 cm of my bowel.”


Because it had spread to a lymph node, Ms Welch had to undergo chemotherapy, which has left her without feeling in her feet.


Over the next four weeks, Bowel Cancer Australia is encouraging people to petition the House of Representatives to ensure Australians with bowel cancer symptoms or a positive screen, receive a diagnostic colonoscopy with a maximum wait time of 120 days, no matter where in Australia they live.


2 March 2018.