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Why wait for a colonoscopy? An easy cure.

A Shoaib1, A Hamade, A Zia

  • 1Department of Colorectal Surgery, William Harvey Hospital, Ashford, UK.

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|June 21, 2006
PubMed
Summary
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Applying new colonoscopy guidelines could significantly reduce patient waiting lists and unnecessary procedures. Reviewing notes revealed most patients on the waiting list no longer required colonoscopy, saving significant costs and time.

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.

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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.