Backlog for colonoscopies in N.S. jeopardizing doctors’ ability to detect colon cancer early

The number of people on a wait-list for a colonoscopy in Nova Scotia has reached 14,000, a backlog that one doctor is calling very concerning.

Nova Scotia Health already sends home screening kits to all Nova Scotians aged 50 to 74 who have signed up for MSI every two years as part of their Colon Cancer Prevention Program. While the program seeks to prevent cancer, the waitlist for a colonoscopy is jeopardizing the ability for health care providers to act early when colon cancer is detected, which is imperative given patients have a 90 per cent chance of curing their disease when it is detected early.

In an interview with CityNews Halifax, the head of surgery in Nova Scotia’s central zone, Dr. Gail Darling, said the backlog has been a significant challenge for the province’s Health Authority.

“We're trying to figure out the best way to address this backlog and be more efficient in terms of how we utilize our resources to deliver this care,” she said.

The main reasons for the backlog were the redeployment of health care professionals to address the COVID-19 pandemic, as well as a six-month suspension of at-home screening testing. As Darling said, not only were there limitations on the ability to do colonoscopies, but patients were also reluctant to seek medical care in hospital settings out of fear of contracting COVID-19. 

Darling is calling for a provincial strategy to end the waitlist, noting there are multiple components to the backlog, including physical resources, sterilization, and, ultimately, more health care workers to both perform the colonoscopies and administer anesthesia. 

“It's not just a matter of a doctor going and doing the colonoscopy,” Darling explained. “It’s really a team event, and having the physical space to do it and organizing the process efficiently is very important.”

Another strategy Darling highlighted is a single-referral system that would allow family doctors to refer patients for a procedure rather than send them to a specialist for further examination.

In 2009, then-Minister of Health Karen Casey noted that colon cancer is one of the leading causes of cancer death in Nova Scotia. She pointed out that 800 people in the province are diagnosed each year, and for nearly half of them, the diagnosis is fatal.

According to provincial numbers as of Sept. 2017, the Colon Cancer Prevention Program has identified about 500 cases as well as the detection of more than 4,000 precancerous polyps. But as Darling pointed out, once patients test at-risk for colon cancer, the current nine-month wait for a colonoscopy is causing incredible amounts of anxiety for people waiting to find out whether they have cancer.