Screening despite demand failings

Six district health boards got the goahead to launch a national bowel screening programme, despite not meeting existing demand for colonoscopies.

Concerns have previously been raised that district health boards (DHBs) are not adequately resourced for the programme. There was a risk some people not eligible for the programme would miss out on the procedure used to detect cancer.

But the Ministry of Health is confident the national screening programme – available to people aged 60 to 74 – will not negatively affect other patients. ‘‘The planning, clinical oversight and monitoring of the National Bowel Screening Programme (NBSP) prioritises numerous safeguards to ensure screening does not negatively impact service provision for symptomatic patients,’’ a ministry spokesman said.

Demand for colonoscopy appointments was expected to increase by 20 per cent due to the programme roll-out but had actually increased by

30 per cent. The demand was driven by the increasing and ageing population, coupled with a greater awareness of bowel cancer, the spokesman said.

The NBSP, non-urgent and surveillance colonoscopies were suspended for three months due to the

Covid-19 lockdown but DHBs had worked hard to reduce the backlog since commencing the services again on June 9, he said.

About 1200 people die from the disease each year. If caught early, treatment can be successful.

Documents released under the Official Information Act reveal the decision to green light the NBSC programme in Canterbury on November 3 happened despite the Canterbury DHB not meeting minimum waiting time targets for existing colonoscopy referrals.

An October 12 memo by NBSP senior managers noted the CDHB was behind but they were satisfied with its plan to achieve the targets by mid-February this year. The CDHB was ‘‘well-prepared to commence bowel screening’’, the managers said.

However, they noted it did present a risk to the DHB and the programme. ‘‘Therefore monitoring and reviewing colonoscopy wait time indicators will be required over coming months.’’

The ministry also sought – and received – assurance that the CDHB oncology department had capacity to receive referrals from the NBSP.

In the week beginning December 26, 72 non-urgent patients had waited longer than three months and

164 surveillance patients had waited longer than six months.

CDHB planning and funding manager Ralph la Salle said that since the NBSP launched in Canterbury,

17 people had received a colonoscopy within four weeks of a positive faecal occult blood test.

‘‘Most recently we have been working with an outsourcing provider to support us in delivering an increased number of colonoscopies, as well as ongoing review work to ensure those who are most urgent are seen first.’’ About 100 cancers and

1000 pre-cancerous growths are expected to be detected in the first year. As of January 14, about 4000 faecal occult test kits had been sent out and more than 1000 returned.

Of those returned, 70 tests came back positive and 17 colonoscopies had been completed.