Why wait for a colonoscopy? An easy cure.

Area of Science:

• Gastroenterology
• Health Services Research
• Oncology

Background:

• Long colonoscopy waiting lists exist in the Kent and Medway cancer network, with 3,549 patients awaiting procedures.
• New guidelines for polyp, cancer, inflammatory bowel disease (IBD), and family history surveillance have been introduced.

Purpose of the Study:

• To evaluate the impact of new colonoscopy surveillance guidelines on existing patient waiting lists.
• To determine the proportion of patients on the waiting list who would no longer meet criteria for colonoscopy under the new guidelines.

Main Methods:

• Compared existing colonoscopy indications with Association of Coloproctology of Great Britain and Ireland (ACPGBI) guidelines using 411 patient records from one hospital's waiting list.
• Analyzed 192 colonoscopies performed across seven regional hospitals to assess guideline adherence and calculate potential impact on waiting lists.

Main Results:

• In one hospital, only 24% of 411 patients on the waiting list met criteria for continued surveillance; 34% were cancelled, and 42% were rescheduled.
• Among 192 performed colonoscopies, 38% were for surveillance, with two-thirds not adhering to guidelines.
• Implementing guidelines reduced urgent diagnostic colonoscopy waiting times from 12 to 4 weeks and routine from 40 to 15 weeks.

Conclusions:

• Approximately 25% of annual colonoscopies (8,000) in the region are unnecessary based on current guidelines.
• Reviewing patient notes could remove over 75% of patients from the current waiting list.
• Guideline implementation could save an estimated £1 million annually and decrease diagnostic colonoscopy waiting times.