Riana Manul, CEO of the new Māori Health Authority, talks on bowel cancer, bowel cancer screening and the launch of a new campaign encouraging Māori and Pacific Islanders to perform self check-ups for bowel cancer. Video / NZ Herald
More than two-thirds of the 509 people on the waitlist for a colonoscopy in Te Whatu Ora Lakes are waiting longer than the recommended or maximum timeframes.
Te Whatu Ora Lakes chief operating officer Alan Wilson said some patients were waiting longer "than is clinically desirable" but was taking stepsto address the issue.
In the Te Whatu Ora Lakes district, the total number of patients on the colonoscopy waitlist at the end of August was 509.
Of these, 233 were waiting longer than the recommended time, and 159 had been on the waitlist longer than the maximum period — the longest the waitlist has been since 2017.
Nationally more than 14,500 people were on the waitlist for a colonoscopy, according to data published by the National Screening Unit last week.
Wilson said timely access to colonoscopies was important and the earlier cancers were detected, the better the outcome and more likely that treatment would cure the patient.
The district had experienced significant challenges with staffing and capacity around endoscopies, the type of procedure that includes colonoscopies and bronchoscopies.
"Some patients are waiting longer than is clinically desirable," Wilson told the Rotorua Daily Post.
"[This can be due to] insufficient hospital resources to provide the procedure in a timely manner."
Wilson said longer wait times could also be due to patient issues.
"[For example,] patients choosing to reschedule their appointment or not attending their colonoscopy for a variety of reasons."
Wilson said the district has now returned to pre-Covid-19 hospital capacity for colonoscopies and was also contracting with external providers to reduce long waits for the procedure.
"The third gastroenterologist has now been replaced and additional endoscopists will be available from January and July 2023.
"This will ensure we are able to work well within the clinically accepted waiting times."
Te Whatu Ora Lakes chief operating officer Alan Wilson. Photo / Andrew Warner
Waiting longer than the recommended time was defined as 14 calendar days in the urgent colonoscopy category, 42 calendar days for non-urgent and 84 calendar days for surveillance. Waiting longer than the maximum time was defined as 30 calendar days for urgent, 90 calendar days for non-urgent, and 120 calendar 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.
Patients can also be referred for an urgent colonoscopy if they are a known or suspected cancer case.
Bowel Cancer New Zealand nurse support co-ordinator 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.
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."
