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then withdrawn and a replacement issued late yesterday
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
''[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.