14,000 on surgical wait-list for colonoscopies in Nova Scotia

Pierre Igot has learned to deal with, and suffer through, the abdominal pain and discomfort of irritable bowel syndrome — after all, the 54-year-old Nova Scotia man has had the disorder since his mid-teens.

But Igot is finding it hard to cope with the wait for a colonoscopy to determine whether symptoms that started last November, for which he has sought emergency care at least three times, are related to his condition or something more alarming.

"Since those are new symptoms that I have never experienced before, I am, of course, worried that I have something more serious than my chronic condition — something more serious, like Crohn's disease or even bowel cancer," Igot told CBC News.

"I cannot rule those out. The doctor cannot rule those out, and the only way to find out is to get a colonoscopy, so I'm worried that I have something serious that I can't do anything about it until I get a colonoscopy done."

The Annapolis Royal man is one of about 14,000 Nova Scotians who were on the surgical wait-list for a colonoscopy last month. According to Nova Scotia Health, in April, the average wait time for someone to see a specialist for a referral was 74 days. The average wait from referral to procedure was 211 days.

That nine-and-a-half month wait is an increase from the pre-pandemic wait time of roughly six months.

Another 1,720 Nova Scotians are waiting for a colonoscopy because blood was found in stool samples they provided the province as part of Nova Scotia's Colon Cancer Home Screening program.

People 50 years or older are regularly screened for the possibility of colon cancer, as part of the Nova Scotia Health Cancer Care Program's early detection program.

Colonoscopy wait times for that program are shorter than those who are referred for the procedure by a specialist.

According to Cancer Care figures, 90 per cent of people who need a colonoscopy to rule out cancer as part of the program get the procedure within five-and-a-half months.

The number of colonoscopies performed in the province has varied from 24,767 in 2019 to 17,786 in 2020, to 24,562 last year.

During the first wave of the pandemic in April and May 2020, the number procedures dropped to less than 150, roughly 10 per cent of the usual monthly flow.

The number of procedures being performed, so far in 2022 are below normal levels.

'It's a very long wait time'

It's a delay the woman in charge of surgery in the province's central zone, Dr. Gail Darling, is not entirely comfortable with.

"It's a very long wait time," said Darling in an interview with CBC News. "We know it's a long wait time. This really has put a burden on everyone — first and foremost, the patients who are waiting, and there's nothing worse than waiting.

"Even having a date 10 months from now is better than waiting without a date. The anxiety that that produces is incredible."

The thoracic surgeon said she and her colleagues also worry about the effect of long waits on disease.

"The worry is, of course, that you're taking potentially early, curable cancer and that cancer becomes incurable in the nine months you're waiting," she said. "There is always the worry that we're going to miss the window of opportunity to treat these patients with curable cancers."

Darling said the wait time has grown, in part, because of the anxiety Nova Scotians felt about visiting their doctors or having to go to hospital during the pandemic. That delayed treatment has meant people are now looking for help with more serious ailments and illnesses.

Centralized wait-list under consideration

"And that, in turn, has had a domino effect on the hospital filling up beds with these very sick people," said Darling. "And that, in turn, has impacted surgeries. We've never really seen anything quite like it."

To try to ease the wait for colonoscopies, surgeons and administrators are discussing a centralized wait-list. 

"One of the strategies we're looking at actively is what's called single referral," said Darling. "So you have a single entry point. If you have 10 people needing colonoscopy, they get referred to a central referral and they get referred to the place that can do them first."

As for when things might get better, Darling isn't optimistic for a quick turnaround.

"I think the government would like them to improve in about six months or less," she said. "We're not sure we're going to be able to deliver that."

Darling recommends that patients and their family doctors keep in close contact with specialists, and that they push to have their procedures moved up the list if their conditions worsen or they believe something more serious is happening to them.

Igot is trying to stay positive.

"It might turn out that I don't have anything serious and I'll be very happy," he said. "But until I do find out, I'm of course going to be very worried that I do have something serious."