More than half of Welsh Health Boards in breach of waiting time target for bowel cancer tests

Four out of seven health boards in Wales do not meet the target of patients waiting no more than eight weeks for tests that could diagnose bowel cancer. In some health boards, 60 per cent of patients are waiting beyond the eight week waiting time target.

Figures released today by StatsWales for February 2017 reveal that over 2,000 people are waiting longer than the eight week target set by the Welsh Assembly, with 1,500 of these patients waiting more than 14 weeks. The two key tests to diagnose bowel cancer are colonoscopy and flexible sigmoidoscopy – a camera on a thin, flexible cable inserted through the anus to look at different parts of the bowel. These tests are known as endoscopy procedures.

The four health boards with the highest percentage of patients waiting more than eight weeks for colonoscopy appointments are: Aneurin Bevan LHB (60%), Cardiff and Vale University LHB (51%), Abertawe Bro Morgannwg University LHB (29%) and Cwm Taf LHB (25%).

The four health boards with the highest percentage of patients waiting more than eight weeks for flexible sigmoidoscopy appointments are: Aneurin Bevan LHB (59%), Cardiff and Vale University LHB (59%), Abertawe Bro Morgannwg University LHB (31%) and Cwm Taf LHB (20%).

More than 900 people die from bowel cancer every year in Wales; it’s the country’s second biggest cancer killer and the fourth most common cancer. However it shouldn’t be. It’s treatable and curable, especially if diagnosed early.

Endoscopy procedures can detect cancer at the earliest stage of the disease, when it is more treatable, and even prevents cancer through the removal of pre-cancerous growths (polyps) during the procedures. Nearly everyone diagnosed at the earliest stage of bowel cancer will survive but this drops significantly as the disease develops, so getting timely access to these tests is vital.

Increasing demand for these tests and a lack of capacity in hospitals is the root cause of long waiting times for appointments. The demand for colonoscopy and flexible sigmoidoscopy has been increasing dramatically over the last few years – a trend that is set to continue. This is due to a number of factors including an ageing population and increase in symptom awareness.

The high demand and lack of capacity for endoscopy is impacting the Government’s pledge to deliver what they’ve already committed to:

• Introducing the Faecal Immunochemical test (FIT) to the screening programmes in Wales replacing the current Faecal Occult Blood (FOB) test that is used. As FIT is a test that can be adjusted to make it more or less accurate at detecting blood in the stool, it is essential that it is introduced at a level that reduces the amount of missed cancers and prevents cancer from developing. A lack of capacity at hospitals could prevent FIT being introduced at its most sensitive level as this will increase the number of people being referred for bowel cancer tests.

Asha Kaur, Head of Policy and Campaigns at Bowel Cancer UK, says: “These figures are very disappointing, especially as waiting times in Wales have been high for some time now. It is unacceptable that patients are being made to wait more than eight weeks for endoscopy tests. How soon someone is seen determines how early a diagnosis can be made. If discovered at the earliest stage, nine out of ten people will survive bowel cancer yet this drops significantly as the disease develops and spreads. This is why early diagnosis is so vital.

“We’re yet to see any commitment from the Welsh Government that would substantially increase the capacity of endoscopy for health boards to enable them to see patients within the waiting time target. There also needs to be a comprehensive assessment of current and future demand for the service so they can better plan what capacity is needed.

 “Given the wide ranging impact that increasing demand and a lack of capacity is having on the ability to provide timely access to tests that can diagnose bowel cancer, the case for urgent investment is clear. Investing in early diagnosis services for bowel cancer is critical to ensuring endoscopy units have sufficient workforce and infrastructure to carry out tests and that all units are working as efficiently as possible.

“That’s why we are calling for a national endoscopy strategy and a training programme as a solution to the mounting pressure on endoscopy units. We hope to work with Government, NHS in Wales and medical professions to ensure a sustainable endoscopy service that has the capacity to meet the challenges of the 21^st century.”

Sam Gould, 33, from Wales was diagnosed with advanced (stage 4) bowel cancer this month, which has spread to his liver and lymph nodes. Sam says:

“The diagnosis was a terrible shock for me and my family, my wife Caroline and our three children, Olivia aged 5, Louisa aged 3 and Pippa aged 1.

Like most men, I tend to discount concerns about my health, but I developed a lot of pain and was bleeding when I went to the toilet. I realised that I could have bowel cancer, but at first the doctor thought I was too young and put me on a 30 week waiting list for a hospital appointment, rather than the urgent cancer referral list which was two weeks long.

After pleading with the endoscopy department for any cancellation or appointment possible I was able to get a quicker appointment, which confirmed that I did have cancer. You can find out more about my diagnosis by watching my video on YouTube. 

I have since had an operation to remove the tumour around the size of an apple and will begin chemo in about eight weeks’ time.”

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