Delays add to bowel cancer patients' waiting time

New Zealand has no specific standard for the timeliness of bowel cancer treatment. Photo / Getty Images

Nearly one-third of patients with bowel cancer wait too long for treatment in Auckland, often because of delays in diagnostic tests, a study has found.

The study, published in the New Zealand Medical Journal, checked the records of 1128 patients treated in public or private hospitals in the region in 2001 and 2005. The median time from initial referral to first treatment was 35 days.

But 32 per cent of patients waited for more than 62 days following referral to a specialist, to receive treatment. The proportion who waited more than 62 days, Britain's guideline maximum wait, was much higher in the public sector than the private - 34 per cent compared with 16 per cent.

New Zealand has no specific standard for the timeliness of bowel cancer treatment, for which the definitive treatment is mostly surgery, although maximum waiting times are set for cancer radiation therapy under the Government's health targets.

The Cancer Control Strategy's broad aim is "timely access to treatment currently recognised as providing optimal outcomes".

Under Britain's guideline, patients with an urgent GP referral for suspected cancer are meant to receive their first "definitive" treatment within two months of that referral.

The journal paper says a common cause of delays in Auckland was the wait for outpatient colonoscopy - a diagnostic investigation of the large intestine with a flexible viewing tube - "with reasons for long wait times including apparent loss of referrals, resulting in multiple referrals ... being made". Some cases required up to three referrals.

Further improvements in services are needed and reducing treatment delays should improve outcomes for patients, say the researchers, who include the clinical head of colo-rectal surgery at Waitemata District Health Board's North Shore Hospital, Mike Hulme-Moir.

Colonoscopy capacity is a key issue in the development of the pilot bowel cancer screening programme at Waitemata DHB.

Dr Hulme-Moir said colonoscopy capacity had increased since the study.

"There's been a big increase in the number of people scoping since 2005 and more efficient use of resources, and also Waitakere Hospital is online doing endoscopy - so more [colonoscopy] is being done."

Although a screening programme would increase colonscopy demand, it should also, by earlier detection, reduce the number of people coming in with advanced bowel cancer.

The head of the Health Ministry's cancer programme, Dr John Childs, said that although there had been improvements since 2005, it was accepted that some patients were waiting too long and there was a commitment to improve.

The maximum time to treatment set in the British guideline was accepted by national cancer working groups in New Zealand as a good standard for to set for bowel cancer - and also lung cancer.

Dr Childs said: "It will probably apply to a whole lot of other cancers as well."