Time to Endoscopy in Patients with Colorectal Cancer: Analysis of Wait-Times

Abstract

Objective. The Canadian Association of Gastroenterology Wait Time Consensus Group recommends that patients with symptoms associated with colorectal cancer (CRC) should have an endoscopic examination within 2 months. However, in a recent survey of Canadian gastroenterologists, wait-times for endoscopy were considerably longer than the current guidelines recommend. The purpose of this study was to evaluate wait-times for colonoscopy in patients who were subsequently found to have CRC through the Division of Gastroenterology at St. Paul's Hospital (SPH). Methods. This study was a retrospective chart review of outpatients seen for consultation and endoscopy ultimately diagnosed with CRC. Subjects were identified through the SPH pathology database for the inclusion period 2010 through 2013. Data collected included wait-times, subject characteristics, cancer characteristics, and outcomes. Results. 246 subjects met inclusion criteria for this study. The mean wait-time from primary care referral to first office visit was 63 days; the mean wait-time to first endoscopy was 94 days. Patients with symptoms waited a mean of 86 days to first endoscopy, considerably longer than the national recommended guideline of 60 days. There was no apparent effect of length of wait-time on node positivity or presence of distant metastases at the time of diagnosis. Conclusion. Wait-times for outpatient consultation and endoscopic evaluation at the St. Paul's Hospital Division of Gastroenterology exceed current guidelines.

Information experiences, needs, and preferences of colonoscopy patients

“…Since there is increasing use of direct-to-colonoscopy procedures to reduce wait times, [27,28] it is important to determine what type of information might make patients more comfortable with such a process. In our study, the predictors of willingness to go direct-to-colonoscopy for a future colonoscopy were the amount of different types of information received, being satisfied with the information received for the current colonoscopy and coming direct-to-colonoscopy for their current colonoscopy.…”

Independent Heath Facility Meets Cancer Care Ontario and Canadian Association of Gastroenterology Guidelines for Endoscopic Procedure Wait Times While Meeting Quality Indicators: A Retrospective Review

“…As a result, patient wait times from evaluation of symptoms concerning for gastrointestinal malignancy to diagnostic endoscopy are lengthening. In addition, the wait times are longer than the recommended maximum wait times set forth by the CAG and CCO [ 12 , 13 ]. In 2010, Sey et al reported that 46% of patients diagnosed with colorectal malignancy (N = 106) in London, Ontario, were subject to wait times longer than the recommended standard of care [ 14 ].…”

“…In 2010, Sey et al reported that 46% of patients diagnosed with colorectal malignancy (N = 106) in London, Ontario, were subject to wait times longer than the recommended standard of care [ 14 ]. Similarly, in a 2015 Canadian hospital-based practice of ten gastroenterologists, Janssen et al reported that 58% of patients diagnosed with colorectal cancer (N = 246) experienced wait times longer than the recommended 60 days [ 13 ]. It has been suggested that the use of IHFs to provide patients with endoscopy is an option to decrease patient wait times by offsetting the workload of hospital-based endoscopic practices.…”

AEG-SEED position paper for the resumption of endoscopic activity after the peak phase of the COVID-19 pandemic

“… 14 Other studies evaluating the waiting list time of CRC patients have also observed no difference in the proportion of more advanced cases when comparing delays of more and less than two months. 15 …”