Wait times from an abnormal fecal test result to follow-up colonoscopy are decreasing, but no provinces have achieved 90th percentile wait times within the 60 day target.
The median and 90th percentile wait time between an abnormal fecal test result and a follow-up colonoscopy required to resolve the diagnosis among people screened by provincial colorectal cancer screening programs in 2013 and 2014. The results are reported by province.
60 days from an abnormal fecal test result to follow-up colonoscopy, recommended by the Canadian Association of Gastroenterology.1
The 2012 Cancer System Performance Report.
Why measure this?
Timely resolution of an abnormal fecal test result leads to a shortened period of uncertainty and less anxiety for people who turn out to have a negative diagnosis (no cancer) and to earlier detection and prompt initiation of treatment for people with a positive diagnosis (cancer), which could improve treatment outcomes. For example, early detection of colorectal cancers through screening using the guaiac fecal occult blood test and removal of polyps during follow-up colonoscopy—the recommended diagnostic test for follow-up of an abnormal fecal test result—has been shown to reduce colorectal cancer mortality.2 As a result, a wait time target based on pan-Canadian consensus on the medically acceptable wait time from abnormal fecal test to follow-up colonoscopy has been set.1
What are the key findings?
- In 2013 and 2014, 90th percentile wait times from an abnormal fecal test result to follow-up colonoscopy ranged from 104 days in Newfoundland and Labrador to 151 days in Prince Edward Island (seven provinces submitted data) (Figure 3.3). None of the provinces had 90th percentile wait times below the 60 day target.
- From 2011–12 to 2013–14, 90th percentile wait times decreased for all provinces (Saskatchewan, Manitoba, Prince Edward Island and Newfoundland and Labrador) that reported data for the two time periods; the decrease ranged from four days in Prince Edward Island to 55 days in Newfoundland and Labrador (data not shown).
Why do these findings matter?
Although wait times are decreasing, many people with an abnormal fecal test result continue to wait several months for a follow-up colonoscopy needed to resolve the diagnosis. Timely resolution of an abnormal fecal test result can reduce the stress and anxiety patients and their families experience. As of 2012, all provinces had developed or were developing organized colorectal cancer screening programs. It is important to note, however, that colorectal cancer screening programs are still in the early stages of implementation in some provinces. Improvements may be seen as the programs mature. Improving colorectal cancer diagnosis wait times requires that many parts of the system involved in screening and diagnosis colorectal cancer work together at multiple levels to drive for efficient processes and minimize wait times.
- Paterson WG, Depew WT, Pare P, Petrunia D, Switzer C, Veldhuyzen van Zanten SJ, et al. Canadian consensus on medically acceptable wait times for digestive health care. Can J Gastroenterol. 2006 Jun;20(6):411-23.
- Hewitson P, Glasziou P, Watson E, Towler B, Irwig L. Cochrane Systematic Review of Colorectal Cancer Screening Using the Fecal Occult Blood Test (hemoccult): An Update. Am J Gastroenterol. 2008;103(6):1541-9.