KEY POINTS:
Bowel cancer patients who have to wait too long for urgent tests at public hospitals face a higher chance of dying from the disease.
Middlemore and North Shore Hospitals are paying for patients to have the internal tests at private hospitals because the public system cannot cope with the volume of testing.
Auckland City Hospital is sending patients to the private sector too, but says this is because of refurbishment work that has increased waiting times.
The test is called colonoscopy. It investigates the lower intestine - the colon - with a flexible surgical tube fitted with a tiny video camera and surgical instruments to remove precancerous polyps and to take samples of potential cancers for diagnosis.
A survey in the New Zealand Medical Journal found major colonoscopy delays nationally for patients with symptoms suggestive of bowel cancer, such as rectal bleeding and changed bowel habits. The authors attribute the delays to shortages of specialised nurses and doctors.
Andrew Connolly, the clinical director of surgical services for the Counties Manukau District Health Board, which runs Middlemore, said yesterday that it had sent a backlog of colonoscopy patients to the private sector, which had led to more cancers being diagnosed.
"With one or two patients, I have concerns that [because of] the time between being referred and the time of colonoscopy the cancer has grown significantly. That can significantly worsen their outlook."
He called for more resources to be put into colonoscopy. "We need to do more colonoscopy. We have delays that we believe are unacceptable."
The Journal survey found that 828 patients with symptoms suggestive of colorectal cancer had waited for more than six months for colonoscopy.
Under national guidelines they should have been tested within eight weeks. The survey was done in 2005, but the Health Ministry now says delays remain an issue.
Mike Hulme-Moir, a colorectal surgeon at North Shore Hospital, said last night that it had been sending colonoscopy patients to the private sector for about six weeks.
He had also noticed a subsequent increase in the number of patients with bowel cancer. He was unaware of any patients whose cancer was more advanced from having a long wait for colonoscopy.
"But I've had people with delays on the colonoscopy list who have had cancer as opposed to benign polyps.
"I had someone recently who waited two years. They have cancer. If they had had colonoscopy two years ago it might have been benign polyps. They need an operation now."
Health Minister Pete Hodgson refused to be interviewed about colonoscopy delays.
Ministry principal adviser for cancer control Dr John Childs said the ministry needed to talk to various groups about expanding the colonoscopy workforce, including the idea of training nurses to do the tests.
