The number of patients overdue for an endoscopy in Canberra has blown out to 6,000, as doctors warn the long public wait times for the common cancer-screening test are "catastrophic" and pose a "high risk".
The public endoscopy waiting list of 7,300 is slightly larger than it was two years ago, but the huge proportion of people overdue has worried health professionals.
Common types of endoscopy services are a gastroscopy, which can be used to diagnose stomach and oesophageal cancer, and a colonoscopy to diagnose bowel cancer and other diseases.
Canberra man Tony, 79, whose surname has been reserved to protect his privacy, is one of those overdue for a colonoscopy.
Known for being the neighbourhood handyman, Tony describes himself as "reasonably fit" but admits he is concerned by the delayed procedure.
"I think it's pretty pathetic really that myself and heaps of other people have to wait this amount of time, particularly [in] my case for a reasonably simple procedure," Tony says.
"It just doesn't make sense."
'I think they're spending money in the wrong places'
Tony returned a positive result in a national bowel cancer screening test in 2016.
To be seen as soon as possible, he opted to pay about $2,000 to go private for his first colonoscopy.
His gastroenterologist removed multiple polyps to avoid them potentially developing into cancer. More polyps were found in a later colonoscopy in the public system just six months later.
But Tony has been waiting longer than clinically recommended for a follow-up examination.
"I thought it was pretty poor because I was concerned, I didn't know what the result would be or if things would get worse," he says.
In 2021, Tony wrote to ACT Health Minister Rachel Stephen-Smith, who replied with an apology for the "distress and frustration" caused by the delay while acknowledging "waiting times are long".
A year later, with no action, he wrote to opposition health spokeswoman Leanne Castley.
Soon after, he was booked in for a colonoscopy later this month.
"I don't think it's right, and I think they're spending money in the wrong places. I think more people need health services than need a tram," Tony says.
Patients wait more than a year on average
Public patients had an average waiting time of 399 days for an endoscopy in the ACT as of October last year, according to Canberra Health Services (CHS) data.
Data is not yet publicly available for the period after the Digital Health Record came online in early November.
Australian Medical Association (AMA) ACT president-elect Kerrie Aust, a Canberra GP, says having 6,021 patients overdue poses a "high risk".
Dr Aust says "urgent" and "priority" patients are meant to be seen within 30 days.
"We've seen that in some cases some people have been waiting an average of more than 200 days, which potentially means that we are missing a very manageable cancer before it gets out of control," Dr Aust says.
Another GP describes the waiting list for endoscopy services as "catastrophic", and says they go to great lengths to ensure their patients are seen sooner — including by appealing to private specialists to charge only a minimal fee.
"I've had patients travel to Wagga for scopes, I've had patients who've taken out a loan to ensure that they have a private scope as quickly as possible, and it's unfortunate that we're having to go down those pathways," Dr Aust says.
She says that for patients to be seen within the clinically recommended time, they need to go private.
Ms Castley says the delays on the public list are "very concerning" and Canberrans shouldn't need to wait years for treatment.
"It's something that the health minister really needs to be addressing because 6,000 people waiting for crucial operations that determine whether they have cancer or not … it's absolutely critical that this gets sorted out," Ms Castley says.
Double public endoscopy suite capacity to address wait list: AMA
Ms Stephen-Smith acknowledges the wait times are too long and says all jurisdictions are unable to meet the demand for scopes.
She puts it down to the "uptake of the national bowel cancer screening program, an ageing population and increases in lifestyle-related gastro-intestinal problems".
ACT Labor promised at the 2020 election to provide an extra 5,000 endoscopy procedures a year by 2023, and to inject $16 million over three years to expand endoscopy facilities at the Canberra Hospital.
In a statement to the ABC, Ms Stephen-Smith did not say if the procedure target would be met, referring only to $7.9 million for additional scopes through extra operating hours, including Saturday lists at the hospital.
An expansion of the hospital's endoscopy suites is still at the feasibility and design phase.
The AMA says Canberra gastroenterologists have been warning since 2009 that more suites will be needed, and the number needs to at least double to five to meet current demand.
"Currently, the service has capacity to perform approximately 5,000 scopes per year, so when the wait list is well over that number we're really looking to the ACT government to provide a plan on how that's going to be addressed," Dr Aust says.
The Canberra Hospital serves a large number of regional NSW residents, and CHS is working with NSW health authorities to encourage them to take more of their own patients — 92 procedures were diverted to Queanbeyan in the past few months.
CHS says it is "unable to identify any patient that developed a cancer during their wait time for a procedure".
Bowel Cancer Australia spokeswoman and colorectal surgeon Penelope De Lacavalerie says studies have long suggested that delays in colonoscopy increase the risk of bowel cancer progression and death.
"Delayed diagnosis leads to delayed treatment. Delayed treatment leads to poor outcomes and unnecessary deaths," Dr De Lacavalerie says.
"We need to ensure colonoscopy wait times are reduced from months to weeks to days to ensure the best health outcomes for Australians."
