Colonoscopy cases revisited

Hundreds of people turned down for surveillance colonoscopies at Dunedin Hospital in recent years are being contacted to see if they still need one.

In 2007, Dunedin Hospital largely stopped doing surveillance colonoscopies for people with increased risk of bowel cancer because the gastroenterology department was overloaded.

Emeritus Prof Gil Barbezat, a retired gastroenterologist and former department head, said yesterday the department limited the procedure to patients with symptoms, except for a small number of people with a hereditary syndrome.

''The symptomatic patients they were getting were becoming more and more acute,'' he said.

The recent move back to surveillance of high-risk patients put the hospital in line with national referral criteria. Southland Hospital has always offered surveillance colonoscopy, and it was standard in many other parts of the country, Prof Barbezat said.

Surveillance colonoscopies are for people with an increased risk of bowel cancer because of their family history.

Southern District Health Board has been reluctant to release information about the initiative, issuing a statement more than a week after the Otago Daily Times inquired. That was then withdrawn and a replacement issued late yesterday afternoon.

Gastroenterology clinical leader Dr Jason Hill said about a third of about 320 patients had been contacted. Once it was known how many patients still needed the procedure, a strategy would be developed to manage them. The extra work would not affect other patients' waiting times, Dr Hill's statement said.

''[Contacting the patients] is the result of local implementation of national guidelines and has occurred as part of the ongoing improvement of gastroenterology services,'' the statement said. Prof Barbezat said some patients were likely to have developed polyps or bowel cancer in the interim.

Some patients would have paid for a private colonoscopy, in which case their public procedure could be deferred, depending on when they went private. Some people would be over the age of 75, and would no longer qualify.

Depending on uptake, he estimated it could take the unit two years to catch up on the surveillance work, which would be staggered over that time.

''These people do have a reason to be anxious, and do have a greater risk compared to the population at large.''

Prof Barbezat hoped the move provided further prompting for the board to make a decision on upgrading Dunedin's endoscopy facility. He was not privy to details, but understood there were positive signs in that regard.

In the past year, the board has shelved two multimillion-dollar upgrade plans, saying last month it needed to go back to the drawing board. A National Health Board assessment in 2011 described the Dunedin facility as poor, not conducive to good and safe clinical practice, and having a risk of infection, a lack of timely access, and lack of patient privacy.

- eileen.goodwin@odt.co.nz

Colonoscopies

I agree, it is sad for Dunedin as well as Otago not to have had regular colonoscopies available. I am disturbed to read a comment by one reader stating something along the lines of having it done every 10 years. I find that time span appalling. I live in Western Australia and although I elected to to pay for private health insurance the standard timespan here is 2 to 3 years depending on what was found the first time.

Colonoscopies and Dunedin

Sad for Dunedin , a teaching hospital, very little cost to the hospital, just a theatre space and a wand + a bit of anesthesia. Why can't junior doctors spend time doing this with suspect cases followed up by their peers ?

Why not me for free health-care?

I am 77 and cannot understand why I do not "qualify" for a free colonoscopy due to a statistical cutoff at age 75. Can anybody explain?

Lack of confidence

Being one of those people refused a colonoscopy for hereditary surveillance, I hope they call me before I turn 75. But I don't hold out any hopes. The medical funding in NZ is appalling and in Dunedin, in a major teaching hospital, to hear that people are dying from infections in surgery as well as risking infection in the gastro division too, does nothing for my confidence in this system.

Colonoscopy

"Prof Barbezat said some
patients were likely to have developed polyps or bowel cancer
in the interim."

Or died. This story is truly shocking. Colonoscopies have largely eliminated bowel cancer among those who receive them routinely (every 10 years). New Zealand is a wealthy country. It can afford to offer them as other countries do.

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