Health Minister Andrew Little on why it took five years for the national bowel screening programme to arrive in the Bay of Plenty - the last DHB region to have it.
A bowel cancer survivor says the waitlist for a colonoscopy in the Bay of Plenty halving within the past year is "really impressive".
However, the national waitlist was more than 14,000 strong - just under 500 locally - and was considered unacceptable by Bowel Cancer New Zealand.
In August, 483 people were waiting for a colonoscopy in the Te Whatu Ora Bay of Plenty district, of which 98 - or 20 per cent - were waiting longer than the recommended or maximum timeframes.
The number of people on the waitlist had reduced by 45 per cent compared to the same time last year when nearly 900 people were on the list.
Bowel cancer survivor Rachael Ferguson was impressed by how much the local numbers had reduced since last year.
Ferguson said long wait times for a colonoscopy could leave people feeling neglected.
"If you've been given an urgent referral and your case isn't being treated as urgent then where does the trust go? You feel like you're not important.
"It could very well be too late for some people by the time they're seen."
Ferguson said she did not know how patients were prioritised.
"How do you figure out who is urgent and who is not? All symptoms are valid and should be taken seriously."
The waitlist was 483 at the end of August in Te Whatu Ora Bay of Plenty.
Of those, 79 were waiting longer than the recommended time and 19 had been on the waitlist longer than the maximum period.
Nationally, more than 14,800 people were on the waitlist for a colonoscopy, according to data current to the end of August published by the National Screening Unit on October 5.
The National Screening unit defined "Waiting Longer than the Recommended Time" as 14 calendar days in the urgent colonoscopy category, 42 days for non-urgent, and 84 days for surveillance.
There are more than 400 people waiting for a colonoscopy in the Te Whatu Ora Hauora a Toi Bay of Plenty district. Photo / NZME
The category, "Waiting Longer than the Maximum Time" was defined as 30 calendar days for urgent colonoscopies, 90 days for non-urgent, and 120 days for surveillance.
The data did not include colonoscopies funded by "other sources" such as ACC, unplanned procedures, or paediatric colonoscopies.
People on the waitlist for surveillance colonoscopies, used to monitor people with increased risk of cancer, were only counted if their procedures were scheduled within the month of the data being reported.
Patients can be referred for a colonoscopy in either two-week (urgent) or six-week (non-urgent) timeframes.
Bowel Cancer New Zealand nurse support coordinator Victoria Thompson said colonoscopies were considered the gold standard in the detection and prevention of bowel cancer.
"It allows the endoscopist to check the entire bowel, remove any polyps for assessing if they are benign or pre-cancerous," Thompson said.
"It also allows any other abnormalities to be removed and they can take biopsies from different areas of the bowel to check for overall health."
Thompson said delaying colonoscopies could potentially allow a tumour to grow and spread.
"Delays can mean the difference between finding an early stage bowel cancer and one that has either grown, spread to nearby lymph nodes, or even further to liver or lung."
Thompson said she had heard from patients that wait times were generally a minimum of four weeks and as long as eight or more weeks for urgent colonoscopies.
Te Whatu Ora Bay of Plenty interim district director Pete Chandler. Photo / George Novak
Thompson said having more than 14,000 people on the waitlist was not acceptable when looking at New Zealand's bowel cancer statistics.
"For those waiting it is a highly stressful time wondering if they might have cancer, or if it is something else."
Thompson said Bowel Cancer NZ would like to see the CT colonography procedure utilised more which could potentially rule out the need for a colonoscopy.
"[Colonographies are] quicker, cheaper and non-invasive."
Te Whatu Ora Bay of Plenty interim district director Pete Chandler was proud of the improvements in waiting times.
"Improving our colonoscopy waiting times has been our highest performance improvement priority over the past two years.
"Even with the immense disruption of Covid-19 from last December, our clinical, management and admin teams have worked together to deliver an amazing achievement."
Te Whatu Ora Bay of Plenty business leader hospital services medical department Sandra Fielding said all referrals for a colonoscopy were reviewed by a senior medical doctor.
"All symptoms are urgent for the person experiencing them," Fielding said.
"However, grading identifies the symptoms that are most likely to be indications of cancer and prioritises these people as most urgent with the aim of the person being contacted and offered a colonoscopy within 10 working days of being identified as urgent."
If a referral did not contain adequate information, the patient's health records were checked for blood results and health history, Fielding said, and their GP may be contacted for further information.
"Some symptoms are less indicative of bowel cancer. These referrals will be accepted as non-urgent or alternative investigations and advice may be provided to General Practice for ongoing management and re-referral if the situation changes."
Fielding said people experiencing increased symptoms or new changes needed to discuss these with their GP.
