Scottish government advisors debated pausing one of the country’s national screening programme because of major delays in access to tests that can confirm or rule out the presence of bowel cancer.

Early detection of bowel cancer makes survival 14 times more likely, but Public Health Scotland figures show that more than 1,000 people had been waiting for a colonoscopy for a year or more at the end of March.

Screening committee minutes from January, which were published this month, warned a “number of boards are reporting challenges or forecasting challenges in colonoscopy capacity”, and agreed it was important for participants to get transparent messaging about possible delays.

The minutes show members of the national committee expressed disquiet about continuing testing when there could be a long delay in a positive home test and a follow-up procedure.

The Scottish government told healthandcare.scot cancer patients remained a “top priority” and screening participants who need further checks “are made aware of potential delays at the same time as they receive their screening result”.

Ministers say they will be publishing an Endoscopy Renewal Plan as part of the programme to remobilise the NHS and increase clinical capacity.

A leading group for patients with bowel cancer says the delay in undertaking colonoscopy is worrying.

Claire Donaghy, Head of External Affairs (Devolved Nations) at Bowel Cancer UK, said early diagnosis was key and warned that delays would see patients facing worse outcomes.  

Every year around half a million Scots between the ages of 50 and 74 do a bowel screening test.

However the service was paused in March 2020, alongside screening for cervical and breast cancer, because of the pandemic.

The home testing kits began to be sent out again in October, with colonoscopies resuming for those whose results warranted further investigation.

Statistics from Public Health Scotland show near the number of people waiting more than six weeks for the tests have more doubled to 6,500 since March 2020, when the figure stood at less than 3,000.

While the total number of people on the waiting lists has risen from just under 9,000 at the start of the pandemic to nearly 12,000, lists are becoming increasingly skewed towards long waits, with more than 1,000 patients facing delays of more than a year.

The statistics mostly represent patients who have been referred by their GP for further checks, with only a small proportion of screening participants.  

The longest waits are concentrated in a few areas. As of March 2021, NHS Ayrshire & Arran had nearly 400 waiters of a year or more; NHS Greater Glasgow & Clyde another 500; and NHS Tayside more than 100.

Claire Donaghy, of Bowel Cancer UK, says the pandemic has had a “huge impact” on services:

“Bowel cancer is treatable and curable, especially if it’s diagnosed early, and it’s heart-breaking that these delays could mean they face worse outcomes as a result.”

"The NHS has worked hard to safely deliver tests which can diagnose bowel cancer during a very difficult time when it was under great strain, but this long endoscopy backlog needs to be dealt with, and quickly.

“The Scottish Government has committed funding to deliver a national endoscopy recovery plan. This plan must be clear about how funding and resources will be focused, so people in Scotland with bowel cancer can be assured they will get the diagnostic tests and treatment they desperately need, in a timely manner.”

A spokesperson for the Scottish government said infection control measures and limitations on space linked to covid-19 had created capacity challenges.

They added:

“Changes have been made so that screening participants who require further investigation are made aware of potential delays at the same time as they receive their screening result. Public Health Scotland is working with stakeholders to ensure that information to all participants in the screening programme will also have information on potential delays. We expect this to be completed over the summer.

“To specifically support endoscopy diagnostic services we have invested more than £7m in 20/21 on a range of initiatives including waiting list validation and extended working days including weekends.

“We will also publish an Endoscopy Renewal Plan that will specifically support increasing capacity for those patients who require scope-based diagnostics.”

 

Read More: Cancer symptoms more likely to be ignored in pandemic; Open letter to FM makes please over cancer backlog; Call for rapid diagnosis to close deadly cancer gap.

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