When the sa国际传媒 government introduced a screening program for colon cancer last year, it looked like a positive move. Colorectal cancer is the second-leading cause of cancer fatalities, killing about 9,000 Canadians each year.
Moreover, the program is simple and inexpensive. People over 50 are referred by their GP to a local medical lab, where they get a test kit. They take it home, collect a small stool sample and return the kit to the lab.
If blood is found in the sample, the GP will arrange for a colonoscopy. That allows a gastroenterologist to look inside the large intestine with a flexible tube and remove any polyps that might be found (these are small growths that start out benign, but which can progress to cancer if not removed). The procedure also identifies tumours, if any are present.
By some estimates, colonoscopies reduce colon-cancer mortality by up to 70 per cent. In short, this is a valuable and timely new program.
There is, however, a problem. The number of people coming forward to receive colonoscopies has swamped hospitals in Greater Victoria.
While progress is being made, there were still 2,200 people on the waiting list last month, and the median time between referral and treatment was nearly 10 weeks. The recommended maximum is eight weeks.
However, that is only part of the picture. Patients who have symptoms of gut disorder, such as pain and bloating, but no blood in their stool, are being bumped to the back of a very long line.
Yet early-stage colon cancer often produces no bleeding. The same is true of many polyps.
And there are other diseases of the intestines, such as diverticulitis and Crohn鈥檚 disease, that also may not result in blood loss.
Patients with these ailments are waiting as long as six to eight months to be seen. Some are being offered a colonography, which is basically a CT scan. But even here, the wait time is lengthy 鈥� perhaps two to three months.
And while this procedure can find polyps or cancer, it cannot remove them. That means the patient must then join the colonoscopy queue and do some more waiting.
There is, of course, an alternative. Private clinics in Vancouver offer colonoscopies on demand. Wait times are just two weeks, and no referral by a GP is needed.
But the treatment costs between $1,600 and $2,000. That鈥檚 far higher than the $700 that MSP pays physicians in the public system.
It鈥檚 possible, and much to be hoped, that these backlogs are simply a teething problem that time and experience will overcome. Island Health has increased the resources available, and more colonoscopies are being scheduled.
Even so, that鈥檚 little comfort to people whose situation is considered less urgent. Many will still endure long waits with painful or distressing symptoms.
That would be easier to justify if patients with bleeding were significantly more likely to have cancer. But it鈥檚 not clear this is so.
Only four per cent of people screened in the new program turn out to have tumours. That鈥檚 a very small number. It鈥檚 possible that patients who don鈥檛 meet the screening guidelines might have incidence rates nearly as high.
The government was right to introduce this new weapon in the war on cancer. It will pay huge dividends in the future as our population ages, perhaps saving 1,000 lives in sa国际传媒 each year.
However, something must be done, and done now, to broaden access so that everyone with symptoms can be treated, and not just a select few. We鈥檙e heading in the right direction. We just need to get there more quickly.
