Date Published: 7 May 2010

Irish Cancer Society calls for more progress on cutting colonoscopy waiting times

951 patients waiting more than three months for colonoscopy

The Irish Cancer Society is concerned at the continuing trend in the high number of people waiting more than three months to undergo a colonoscopy, the most effective procedure for diagnosing bowel cancer.

According to data provided by the hospitals to the National Treatment Purchase Fund (NTPF), which manages public hospital waiting lists, there are now 951 people waiting more than three months for a colonoscopy. While this represents a minor decrease of 4% since the Society published figures in March, it is the upward trend over the last six months which is most concerning. There are 130 more people waiting more than three months for a colonoscopy since December.

Commenting on the waiting times, Kathleen O’Meara, Head of Advocacy and Communications, Irish Cancer Society said,

“ We are concerned at the potential impact the continued high number of people on waiting lists may have on a screening programme. We warmly welcomed Minister Harney’s announcement on bowel cancer screening which will involve the use of selected hospitals to deliver screening colonoscopies, and to begin in 2012.”

“ However, we believe that unless the problem of waiting lists is tackled in advance of screening being delivered, we are not sure that we can have full confidence in the ability of our hospital system to deliver screening while not impacting symptomatic services at the same time. Clearly improvements have to be seen well in advance of the rollout of the screening programme however they are achieved,” Ms. O’Meara added.

A year ago, Health Minister Mary Harney TD instructed the HSE to ensure that patients needing an urgent colonoscopy should not have to wait more than four weeks following referral from their GP.

Amongst the developments since the Irish Cancer Society's update in March:

• The number of patients waiting more than three months in Beaumont Hospital has gone from 66 to 131 (98% increase and up from 9 people waiting in December 2009)
• There are now 99 patients waiting more than three months in Sligo General Hospital compared to 74 in March (34% increase and up from 44 in December)
• The number of patients in Letterkenny General Hospital has increased again, from 43 in March to 56 according to latest figures. (30% increase, and follows on an increase from 25 people waiting in December)
• Worryingly, the number of people waiting in Galway University Hospital is up 70% with 106 patients waiting for a colonoscopy. (62 patients waiting in March).

However, some hospitals are improving their performance. Where we have seen improvements since March and over the past six months:

• In AMNCH Tallaght Hospital the number of patients waiting more than three months has reduced by 24% since March from 90 patients to 68. (This follows on a 49% decrease since December, from 177 to 90 patients).
• Mid Western Dooradoyle Hospital, Limerick has reduced its waiting list by 57%, with 57 people waiting compared 134 in March.
• Mercy University Hospital, Cork has shown improvement by reducing its waiting list by 32%, down to 104 people waiting from 153.
• Kerry General Hospital has also shown improvement over the past six months, with just five people currently waiting for a colonoscopy, compared 113 in September. (76% decrease since March, when 21 people were waiting).

Since the Irish Cancer Society started to highlight this issue in November 2008, the number of patients waiting more than three months for a colonoscopy has dropped from 1,919 to 951, a reduction of 50%. By comparison, in September 2009 the overall reduction had stood at 72%.

“ While we welcome the considerable progress hospitals have made since we first drew attention to the problem in 2008, the Irish Cancer Society is seriously concerned to see that the total number of people waiting has increased by over 30% in just over six months. This means that 229 more patients are now waiting for colonoscopies than there were in September 2009. We hope this arrest in upward increases in the past month kick-starts the trend once more in the downward direction and that the numbers waiting will continue to decrease each time we investigate the issue,” said Ms O’Meara.

While some of the figures may include patients who have been called for a colonoscopy and were unable to attend or patients scheduled for a repeat colonoscopy, the increases across the majority of hospitals are very worrying.

Irish Cancer Society Nursing Services Manager Joan Kelly said,

" Bowel cancer is the second biggest cancer killer in Ireland, with more than half of new cases being diagnosed in stage 3 or 4, where survival rates are much lower. Awareness of signs and symptoms is crucial and that’s why we designated April as Bowel Cancer Awareness Month. So also is timely access to a colonoscopy."

" We urge people who have been waiting for a colonoscopy in a public hospital for more than six weeks to take action by contacting their GP to see if they can schedule the procedure as soon as possible. If patients are waiting for longer than three months, it’s important to know that you can contact the National Treatment Purchase Fund (LoCall 1890 720 820) to discuss referral for a colonoscopy to a private hospital free of charge. If you are concerned about bowel cancer, you can also speak in confidence with a specialist cancer nurse by calling the Irish Cancer Society’s National Cancer Helpline on Freefone 1800 200 700,’ said Ms Kelly.

Bowel cancer is the second most common cause of cancer death in Ireland, after lung cancer. In 2008 there were 2,216 new cases of bowel cancer and 966 deaths from the disease. Over 50% of patients in Ireland are diagnosed with Stage 3 or 4 bowel cancer – the most advanced stage of bowel cancer. Less than 5% of patients with Stage 4 bowel cancer survive for longer than five years.

Screening

As a crucial step towards ensuring that more people are diagnosed earlier and survive this disease, the Irish Cancer Society is also seeking the implementation of a national bowel cancer screening programme by 2010 for everyone living in Ireland aged 50-75 years. In July 2009 the Irish Cancer Society announced an offer of €1 million towards the rollout of a national bowel cancer screening programme.

At the end of February 2010, Minister Mary Harney announced of a bowel cancer screening programme for the 60 to 69 age group to be rolled out by 2012. We think this is a good start but we will be seeking assurances from the Minister for the completion of the rollout as soon as possible to include the 55 to 74 age group as a crucial step towards ensuring that more people are diagnosed earlier, treated effectively and survive this disease.

Bowel Cancer Warning Signs

Warning signs for bowel cancer include:

• Change in bowel habits lasting more than a month
• Bleeding from the back passage
• Regular feeling of trapped wind or fullness in the stomach area
• Feeling as though there is something left to pass even after bowel movement
• Pain or discomfort in stomach area or back passage
• Weight loss for no apparent reason
• Ongoing tiredness or weakness.

Bowel Cancer Risk Factors

• Age - risk increases with increasing age
• Having a family history of bowel cancer
• Having a family history of polyps (abnormal growths of tissue in the lining of the bowel)
• Having a diet which is high in fat and low in fruit, vegetables and fibre
• Lack of physical activity
• Obesity
• Alcohol
• Smoking

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