B.C.’s health minister wants a backlog of referrals for colon-cancer screening tests in Greater Victoria addressed before the program rolls out provincewide this summer.
A flood of referrals for colonoscopies — the result of a new provincial colorectal-cancer screening program launched by the Vancouver Island Health Authority in April — has overwhelmed two Greater Victoria hospitals.
“Are there things we need to change before we roll it out provincially?… I’ll be asking that of ministry staff,” Health Minister Terry Lake said.
“If we have a goal of increasing the amount of screening we are doing, there is no sense trying to do that if there are obstacles in the way.”
VIHA lobbied to kickstart the program, but just months later, 10 gastroenterologists at Royal Jubilee and Victoria General hospitals say they’ve been overwhelmed with referrals.
The specialists are now refusing further patients. The gastroenterologists say they have an ethical and legal obligation to tell family doctors to refer patients elsewhere in B.C. or to a private clinic. That’s because the eight-week recommended wait time for the procedure following a positive stool test has doubled, said Dr. David Pearson, head of the division of gastroenterologists for VIHA.
In an interview Monday, Lake said the wait times are not acceptable and he’s asking staff for recommendations to speed up the system. If the specialists can’t perform the procedures in a timely fashion, Lake said, he understands their reluctance to encourage doctors to continue to send referrals.
However, VIHA and the health minister caution that the waits are for screening colonoscopies only and that any urgent cases will be treated immediately. The goal of the screening program is to reduce the number of people who show up in hospital emergency departments with urgent cases of advanced colorectal cancer.
Colorectal cancer is the second-leading cause of cancer death in adults after lung cancer.
The new screening program — still scheduled to be expanded across B.C. this summer — gives residents ages 50 to 74 access to take-home stool tests through doctors’ offices. The $35 fecal immunochemical tests are funded by the province.
Stool is checked for traces of blood, which can be a sign of cancerous tumours or pre-cancerous polyps in the colon and rectum.
Patients whose stool tests are positive are referred for a colonoscopy, where an endoscope is inserted to examine the large bowel and part of the small bowel. The scope allows surgeons to look for and remove the polyps or tumours.
VIHA estimates the number of people being referred for a colonoscopy since April has tripled. The health authority says it has hired nurses to address the volume and may expand the hours of the endoscopic unit where the procedure is performed.
The Health Ministry and VIHA are working with Greater Victoria gastroenterologists to increase the number of colonoscopies that can be performed.
“This is why we wanted to do it in one health authority first before rolling it out to other parts of the province,” Lake said, “so we could understand what the challenges would be and learn from those and address those challenges.”
There is no budget cap for the screening program — funding is per procedure from the Medical Services Plan.
“We know how important early detection of colorectal cancer is,” Lake said. “We just need to overcome some of these challenges, and we’re committed to doing that.”
