{"id":160429,"date":"2025-09-22T06:22:16","date_gmt":"2025-09-22T06:22:16","guid":{"rendered":"https:\/\/www.newsbeep.com\/au\/160429\/"},"modified":"2025-09-22T06:22:16","modified_gmt":"2025-09-22T06:22:16","slug":"rural-disadvantaged-patients-get-fewer-early-colonoscopies","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/au\/160429\/","title":{"rendered":"Rural, disadvantaged patients get fewer early colonoscopies"},"content":{"rendered":"

The updated colonoscopy clinical care standard features new guidance on My Health Record. <\/p>\n

An updated clinical care standard for colonoscopy has landed, just as new data paints a picture of growing access inequality across the country.<\/p>\n

According to an<\/a> Australian Commission on Safety and Quality in Health Care (ACSQHC) report<\/a> presented at the World Congress of Gastroenterology and Australian Gastroenterology Week 2025 in Melbourne on Sunday, the past decade has seen an 8% decrease in the number of people receiving MBS-subsidised repeat colonoscopies within three years of their original colonoscopy.<\/p>\n

This overall decrease was far more pronounced in areas of socio-economic disadvantage and in rural areas.<\/p>\n

Australians living in major cities went from receiving around 543 early repeat colonoscopies per 100,000 people in 2013 to receiving 510 early repeat colonoscopies per 100,000 people in 2023, representing a 6% decrease.<\/p>\n

For rural Australians, the rate went from 157 early repeat colonoscopies per 100,000 people in 2013 to 116 early repeat colonoscopies per 100,000 people in 2023, representing a 26% decrease.<\/p>\n

Where the proportion of people in Australia\u2019s least disadvantaged regions who received an early repeat colonoscopy increased by 2% over the decade, the proportion of people in Australia\u2019s most disadvantaged regions who received an early repeat colonoscopy decreased by 17%.<\/p>\n

While there is no hard number on exactly how many people should be having a repeat colonoscopy within three years, GP and ACSQHC medical advisor Dr Phoebe Holdenson Kimura said the levels of variation between groups were cause for concern.<\/p>\n

\u201cThere\u2019s so much variation that it does make us wonder whether some people, particularly in affluent areas, might be receiving repeat colonoscopy too early, unnecessarily,\u201d she told The Medical Republic.<\/p>\n

\u201cAnd equally, [are there] people in those geographically more remote or rural areas, or people in less affluent areas that perhaps do need that repeat colonoscopy, but for whatever reason, they\u2019re not having it?<\/p>\n

\u201cI think, potentially, we\u2019re seeing both of those things happen.\u201d<\/p>\n

The Cancer Council guidelines around surveillance colonoscopy put the interval between initial colonoscopies at either one year, three years, five years or 10 years.<\/p>\n

\u201cIf we\u2019re really adhering to those guidelines fairly closely, then we would only see a small number of people requiring a repeat colonoscopy before three years,\u201d Dr Holdenson Kimura said.<\/p>\n

\u201cFor the purpose of this particular analysis, we\u2019ve decided to make it two years and 10 months, just to allow a little bit of leeway so we\u2019re not counting patients who\u2019ve had it a few months early for a logistical reason, which we don\u2019t think is an issue.\u201d<\/p>\n

\"\"<\/p>\n

Dr Holdenson Kimura encouraged GPs to use the interactive data map<\/a> published by the ACSQHC to get a clearer picture of whether people in their immediate area were receiving early repeat colonoscopies.<\/p>\n

\u201cYou can actually interrogate the data and see how the data compares between where you work or \u2026 [look] at the population which you serve, and go, \u2018this rate is very similar to the rates around us\u2019, or perhaps it\u2019s quite different,\u201d she said.<\/p>\n

\u201cAnd [you can think about] what are the potential causes for that, but also what are the ways that the service can adapt to try and meet the needs of its population?<\/p>\n

\u201cUnderstanding the problem and articulating the problem is the first step \u2026 particularly since we\u2019re seeing that disparity, unfortunately, appears to be widening over the last 10 years.\u201d<\/p>\n

While she acknowledged that no one GP could solve the issue of access and affordability, Dr Holdenson Kimura said there was a role for GPs to play in advocating for patients they were concerned about.<\/p>\n

\u201cIn Australia, only four in 10 eligible people are actually participating in bowel cancer screening,\u201d the GP said.<\/p>\n

\u201cWe know that when GPs have conversations with their patients about screening, patients trust their advice.<\/p>\n

\u201cThey want to follow through on it and it, it\u2019s really the thing that makes the biggest difference.<\/p>\n

\u201cAnd then off the back of a positive faecal occult blood test or the screening test, the GP plays a critical role in referring that patient to have a colonoscopy with really a high-quality referral.\u201d<\/p>\n

Guidance on comprehensive referrals makes up the first part of the new colonoscopy clinical care standard<\/a>.<\/p>\n

The standards now state that each referral should include an indication, presenting symptoms and the clinical concern, results of previous investigations, all relevant medical and family history, current medicines and previous relevant treatment.<\/p>\n

\u201cThose are the sorts of things that can make sure that it\u2019s a safe transition of care for the patient between the primary and the secondary sector,\u201d Dr Holdenson Kimura said.<\/p>\n

\u201cAnd then I think the other big part that GPs can play \u2013 looking particularly at this repeat colonoscopy issue \u2013 is that we know that for patients who have had their colonoscopies \u2026 might be confused or they may not actually know what the plan is for follow up.<\/p>\n

\u201cThe clinical care standard, in the final quality statement, talks really explicitly about the need for clear communication with the patient and written communication as well, but also for the colonoscopist to be proactively communicating with the GP.\u201d<\/p>\n

One of the key additions to the new version of the care standard is a directive to upload the report and results to each patient\u2019s healthcare record and My Health Record.<\/p>\n","protected":false},"excerpt":{"rendered":"The updated colonoscopy clinical care standard features new guidance on My Health Record. An updated clinical care standard…\n","protected":false},"author":2,"featured_media":160430,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[64,63,1617,27396,137],"class_list":{"0":"post-160429","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-au","9":"tag-australia","10":"tag-cancer","11":"tag-gastroenterology","12":"tag-health"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/160429","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=160429"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/160429\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/160430"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=160429"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=160429"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=160429"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}