Bowel cancer: Doctors concerned growing waiting lists for colonoscopies could prove fatal

By Natalie Whiting

Bowel Cancer Australia says less than 20 per cent of bowel screening participants who require a colonoscopy are getting it within the recommended 30 days.

Waiting lists for colonoscopies have been growing across the country, with some patients waiting up to a year to access one in the public health system.

Doctors are concerned the delays are undermining the screening process and could be fatal.

“We have known since 2012 that colonoscopy waiting lists are becoming a big issue in the public setting, starting with Queensland and Victoria, Western Australia more recently and of course Tasmania,” said Julien Wiggins, the CEO of Bowel Cancer Australia.

He said the situation was unacceptable.

“When it comes to the screening program itself, we’re seeing wait times up to six months in particular, however in the public setting in some instances we do know of nine months, in other states it’s four months,” he said.

“Only 17 per cent of people with a positive test are seen within the recommended 30 days.”

Margaret Parker waited 12 months for a colonoscopy in the public system before paying for one privately. The test found two tumours.

“Twelve months is a long time with an aggressive tumour,” she told 7.30.

“Yes, I probably would have had the radiation and the chemo, that would have still been there, but the percentage of success probably would have been higher.”

The Tasmania Health Service last year sent letters to doctors and patients advising of delays in Hobart.

General practitioner Dr Graeme Alexander has been speaking out about the issue in Tasmania.

“We had patients, sitting, waiting on that list where we’re saying to them ‘yes, you might have bowel cancer’.”

In response to the delays the Tasmanian Government put $500,000 towards employing an extra gastroenterologist to work at the Royal Hobart Hospital for 12 months, but Dr Alexander is still concerned.

“It’s not recurrent funding. We are about to go straight back to where we were before,” he said.

National bowel screening program ramping up

More than 2 million people are asked to take part in the national bowel cancer screening program each year, and that is set to rise to 4 million in 2020.

Currently the program accounts for almost 5 per cent of colonoscopies and that is expected to rise to 9 per cent.

The aging population is also adding strain to the system.

Bowel Cancer Australia said the issue was first raised in 2005 during a pilot of the program and that the response from governments had so far been “lacklustre”.

“Certainly at this stage, delays look like they’ll get worse before they get better,” Mr Wiggins said.

“Unless there is some drastic action to change, whereby funding is made available in the public setting to actually deal with the waiting list, to ensure that people who have symptoms or suggestions of bowel cancer, or people who have a positive test, can be seen within the recommended time.”

The Australian Medical Association said the delays were concerning and called for better funding of public health systems.

In a statement, a spokeswoman for the federal Health Department said timely access to colonoscopies was important for not only screening participants, but anyone requiring the procedure.

However she highlighted that the service and associated waiting times are the responsibility of state and territory governments.

The issue is being explored as part of a Commonwealth review of the Medicare benefits scheme.

It has raised concerns that low risk patients with no symptoms who are undergoing colonoscopies for bowel cancer screening or other disorders may be “compromising” access for others.

Litigation risk for state health services

Bowel cancer kills 4,000 people a year, but there is a 90 per cent survival rate if it is caught early.

Medical negligence lawyer Tom Ballantyne from Maurice Blackburn said the delays were creating a serious litigation risk for health services.

“If these waiting lists continue to blow out to many months, eventually you will have people whose disease progresses because of the delay and in those circumstances the risk of litigation is very real,” he said.

It could result in payouts of hundreds of thousands of dollars, or more.

“In one of our previous cases a gentleman waited quite a while for a colonoscopy and he unfortunately had bowel cancer and that had progressed to the point where it was incurable, and the evidence was if it had been picked up earlier it was likely to have been treated properly. That case was successful,” Mr Ballantyne said.

Ms Parker is not in remission yet, but her tumours were not visible on a recent test.

“I’m not the only person who is having this experience. As us baby boomers age more and more of us are going to need to get a colonoscopy,” she said.

“So if the hospitals are not coping now, it’s only going to get worse.”

For support following a cancer diagnosis or more information:

• The Cancer Council, 13 11 20,
• Bowel Cancer Australia,
• Cancer Australia.

This post originally appeared on ABC News.