Abstract
Background Canadian independent health facilities (IHFs) have been implemented to reduce hospital endoscopy volume and expedite endoscopic evaluations for patients suspected to have underlying colorectal cancer. Methods We conducted a retrospective review of a prospective database at a large-volume urban IHF. The primary outcomes were wait times, and the secondary outcomes were colonoscopy quality indicators and complication rates. Results Median wait times from referral to colonoscopy met the recommendations set out by the Canadian Association of Gastroenterology and Cancer Care Ontario for all indications: chronic abdominal pain: 43 days; new onset change in bowel habits: 36 days; bright red rectal bleeding: 42 days; documented iron-deficiency anemia: 43 days; fecal occult blood test positive: 38 days; cancer likely based on imaging or physical exam: 23 days; chronic diarrhea and chronic constipation: 42 days; and screening colonoscopies: 55 days. Secondary outcomes of quality indicators and complication rates all met or exceeded the CCO and CAG recommendations. Conclusions This IHF met the recommended wait times for all indications for colonoscopy while maintaining high procedural quality and safety. IHFs are one solution to help meet the increasing demand for colonoscopy in Ontario.
Highlights
Colorectal cancer (CRC) is the second most common cancer in men, and the third most common cancer in women [1]
The wait times for all colonoscopy indications were shorter than the Canadian Association of Gastroenterology (CAG) and Cancer Care Ontario (CCO) recommendations and almost all colonoscopy indications were shorter at the independent health facilities (IHFs) compared to the wait times reported in the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2008 and 2012 surveys (Table 2)
There has been an increase in demand for colonoscopy in Canada over the last number of years which is reflected by the greater number of colonoscopies that are being performed across Canada on an annual basis
Summary
Colorectal cancer (CRC) is the second most common cancer in men, and the third most common cancer in women [1]. The Canadian Association of Gastroenterology (CAG) Wait Time Consensus Group recommends that patients with symptoms concerning for colorectal malignancy should have an expedited endoscopic examination [3]. Median wait times from referral to colonoscopy met the recommendations set out by the Canadian Association of Gastroenterology and Cancer Care Ontario for all indications: chronic abdominal pain: 43 days; new onset change in bowel habits: 36 days; bright red rectal bleeding: days; documented iron-deficiency anemia: days; fecal occult blood test positive: 38 days; cancer likely based on imaging or physical exam: 23 days; chronic diarrhea and chronic constipation: 42 days; and screening colonoscopies: 55 days. This IHF met the recommended wait times for all indications for colonoscopy while maintaining high procedural quality and safety. IHFs are one solution to help meet the increasing demand for colonoscopy in Ontario
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