Abstract
Introduction: Colorectal cancer is a common cause of cancer in Australia. Also, patients living in regional and rural areas are diagnosed later and have poorer outcomes compared to their metropolitan counterparts. The purpose of this study is to determine the distribution of the workforce providing colonoscopies for the Australian population.Methods: A cross-sectional observational study of the medical practitioners certified by the conjoint committee for the recognition of training in gastrointestinal endoscopy (CCRTGE) was performed. Data regarding their specialty and principal place of practice was collected. The principal place of practice was stratified with the Modified Monash Model (MMM) of rurality and the local government association’s classifications of rural and urban areas.Results: As of March 2021, there were 2698 medical practitioners listed as being recognised in the field of adult colonoscopies by the CCRTGE. Of these, 2123 were found to still have active specialist registration with the Australian Health Practitioner Regulation Agency (AHPRA). In the capital city Local Government Areas (LGAs), there was an endoscopist every 0.33 km2 to 62.05 km2. In the rural LGAs, there was an endoscopist every 23,382 km2 to 267,780 km2. In metropolitan areas, the most common specialty of the endoscopist was gastroenterology whereas in regional cities and remote towns it was general surgery. In very remote towns, general practitioners provided colonoscopy services.
Highlights
Colorectal cancer is a common cause of cancer in Australia
We studied the composition of specialist medical practitioners providing colonoscopies to patients in Australia and their distribution around metropolitan and regional Australia, both in terms of the Modified Monash Model (MMM) and their Local Government Areas (LGAs)
The CCRTGE had 2689 practitioners recognised for adult colonoscopies as of March 5, 2021
Summary
Colorectal cancer is a common cause of cancer in Australia. patients living in regional and rural areas are diagnosed later and have poorer outcomes compared to their metropolitan counterparts. Colorectal cancer is Australia’s third most diagnosed cancer with 17,004 new cases in 2018. It is the second most common cause of cancer death with 4129 deaths [1]. Colonoscopic removal of polyps in patients with positive screening tests, symptoms of colorectal cancer, and strong family history is an effective way of preventing colorectal cancer or detecting it in its early, surgically curable stages [2]. Effective and cost-efficient screening measures have been put into place internationally including Australia low participation rates are preventing its full potential [3]. If found to be positive, the patient is offered a colonoscopy to remove any polyps prior to becoming cancerous or to facilitate early detection of cancer. Colonoscopies are subsidised by the Australian government’s universal health care insurance scheme “Medicare” and take place in public and private hospitals [4]
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