Deficiencies in bowel screen register

LESS than a third of positive FOBT results in the national bowel cancer screening program are being notified to the Medicare Australia register, Commonwealth figures show.While 9575 people in the program have returned a positive FOBT, only 2741 GP assessment forms have been lodged, according to data provided to Medical Observer by the federal health department.

“The data flow back to the registry is falling well short of the mark,” said Adelaide gastroenterologist and national program adviser Professor Graeme Young.

He said that while doctors had a responsibility to fill out the forms “there probably needs to be more communication to improve the process”.

GPs were paid $6.60 for every form lodged in order to maintain a record of colonoscopy referrals and patient outcomes, which ultimately would assist in evaluating the program.

The national program participation rate was around 40%, as expected, but it varied from state to state, the data showed.

At 30 April this year, 6.6% of the 145,380 screenings had returned a positive FOBT. From these positive screens, at least 44 adenomas and 29 suspected cancers had been detected following colonoscopy.

The data also revealed the average patient wait for a colonoscopy after receiving a positive result was 57 days.

Professor Young said this was “at the limit of acceptability” given that many individuals would be waiting even longer.

“A 57-day wait is a fair while for a patient to deal with their anxiety, but appropriate counselling from doctors will help them cope with that.”

A 90-day wait was deemed acceptable for non-life-threatening cases, but it was unknown how many people were having to wait this long, he said.

Meanwhile, a study has found that a lack of money, rather than a shortage of proceduralists as feared, may limit the ability of NSW public hospitals to meet increased colonoscopy demand from the national screening program.

Information provided by 26 major hospitals identified a lack of endoscopic nurses and the need for more equipment as impediments to expansion of services (MJA 2007;187:249-50).

“No unit cited a shortage of proceduralists as a reason for the unit not running at full capacity,” the researchers said.

Eleven out of 15 hospitals with dedicated endoscopy suites had an unused endoscopy room because of insufficient funds, lack of nurses and/or anaesthetists and equipment.