Auditor flags wait for cancer screening

Colonoscopy delays a concern

Saskatchewan people at risk of colorectal cancer are waiting as long as half a year for colonoscopies and results, according to a provincial auditor's report that found participation in a life-saving screening program is slipping.

Judy Ferguson's audit of the Saskatchewan Cancer Agency, published on Tuesday, found lengthy delays in booking patients with abnormal fecal screens that pointed to a heightened risk of colorectal cancer. In the period from Aug. 1 to March 31, 21 per cent of them waited longer than 60 days for a colonoscopy appointment.

The audit found 22 people who were subsequently diagnosed with cancer after a wait at least that long, including one who waited 159 days for an appointment after an abnormal screen.

But even then, the wait wasn't over. Ferguson's team found 12 people diagnosed with cancer who waited longer than the 14day benchmark to get their results, including one person who waited 104 days.

The longest combined wait — to get a colonoscopy and then results — was 184 days.

Colorectal cancer is the second leading cause of cancer death, but it is highly treatable if caught early. Health Minister Paul Merriman said the waits cited in the audit are simply “too long.”

“That's something that we have to improve on and I'm going to be following up with my officials to be able to see where we are at meeting those expectations,” Merriman said.

“Obviously people who are fighting cancer have many challenges, and we don't want the pathology to be one of them.”

Ferguson urged the Saskatchewan Cancer Agency to reduce those wait times. Though she couldn't say whether any of the patients who waited past the benchmarks subsequently died, she warned that lengthy delays compromise care.

“Time is of the essence when it comes to colorectal cancer,” she said. “Anytime that you're slower than those timelines, you're increasing the risks of the patients in terms of delaying that treatment plan.”

Asked who's at fault, Ferguson noted that there are “a lot of players involved.” She said that the delays were most common in regions where family physicians were responsible for booking, not the Saskatchewan Cancer Agency. But she said the approach isn't consistent. She called for “clear guidance” to fix the problem.

She also found cases where the agency itself booked colonoscopies late when non-urgent medical procedures were put on hold due to the COVID-19 pandemic.

While Saskatchewan has the nation's highest participation rates for colorectal screening, Ferguson was worried to see them slip. They fell from 50 per cent in 2014 to 2016, her audit noted, reaching 47 per cent from 2018 to 2020.

Despite efforts to promote screening in northern Saskatchewan, Ferguson found that rates remained persistently low and continued to fall in those areas, with participation between 22 and 34 per cent in the most recent data. She also found low levels of screening in Moose Jaw and Swift Current.

Ferguson urged the Saskatchewan Cancer Agency to analyze its promotional strategies to see if they're working. She noted that it hasn't yet done so.

NDP Health critic Vicki Mowat said the audit shows that the government hasn't been prioritizing the issue.

“There are so many areas in our health care system that need work and have real impact on patients, when they're waiting so long for these essential screenings that detect cancer,” she said.