Stuff Digital Edition

Long delays for young bowel cancer patients

Lucy Xia Stuff

Danielle Turner was just 30 years old when she was diagnosed with bowel cancer in 2020 – after having four colonoscopy referrals declined within six months.

The Hamilton single parent said she visited several doctors frequently over a half-year period to push for her bowel screening after experiencing excruciating and consistent pain and losing 20 kilograms in weight since her initial symptoms.

Turner claims she was told she was too young to have bowel cancer and that it would be unlikely for her colonoscopy referral to be accepted if she did not have a direct relative with the disease.

A chance discovery that her uncle had bowel cancer, combined with a health advocate’s efforts, got Turner a colonoscopy seven months after she first presented with symptoms.

A year on from her cancer surgery, Turner feels lucky to be OK, but said she was ‘‘frustrated, disappointed’’ and ‘‘heartbroken’’ for people who would’ve given up during the process.

Turner isn’t alone in her experience, as young Kiwis continue to be turned down for diagnostic bowel screening.

A study in 2021 showed that globally within the next decade, one in four rectal cancers will be found in adults under 50.

Meanwhile, more than 350 people under 50 are diagnosed with bowel cancer each year.

Coral Sheary, a 34-year-old nurse in Palmerston North, was experiencing diarrhoea up to six times a day and seeing blood in her faeces, before being diagnosed with bowel cancer.

Even with persistent symptoms, Sheary said she, too, was told she was too young, was ‘‘blown off’’ by doctors and told to get tests for irritable bowel syndrome.

She waited five months for a colonoscopy.

Sheary said she had to be ‘‘ruthless’’ to advocate for herself.

‘‘That’s me pushing, and I’m a nurse . . . whereas some people would have just accepted what the doctors say and leave it at that,’’ she said.

Sheary did not have health insurance but was often asked about this during the process.

‘‘It shouldn’t come down to whether you have health insurance or not. It needs to be reviewed how the system works in New Zealand,’’ she said.

For Tanya Pickup, it took a ‘‘massive’’ bleeding incident to get a colonoscopy, after which she was diagnosed with stage-two bowel cancer in November 2021.

This was about one year after she went to her GP with symptoms and seven months after waiting for screening.

Pickup said she was often told by her GP she was too young, and at one point, was even asked by her GP whether she was sure the blood came from faeces, rather than somewhere else.

Pickup believed she’d still be waiting had she not experienced the bleeding which led her to be hospitalised.

The Christchurch-based 40-year-old said despite having diarrhoea up to 20 times a day, an urgent referral by her gastro specialist and a history of bowel perforation from giving birth to her youngest child, they kept her waiting.

Canterbury District Health Board’s (CDHB) chief medical officer Dr Helen Skinner said it couldn’t comment on individual cases but said patients were not prioritised based on people they may know.

Bowel Cancer New Zealand’s medical adviser Frank Frizelle said the country needed to recognise the increasing rates of bowel cancer in young people.

Frizelle said there was lack of resources in publicly-funded bowel assessments and that must change.

He said the ministry also needed to fund more colonoscopies for younger people and called for the national bowel screening programme’s age threshold to be lowered from 60 to 50.

Medical director of the Royal New Zealand College of General Practitioners Bryan Betty said there needed to be increased capacity for colonoscopies, and for GPs to be better equipped to make preliminary investigations – for instance, through easier access to abdominal X-rays.

Betty said GPs were getting frustrated when they saw patients who clinically warranted a colonoscopy, but were declined because they didn’t meet the threshold according to the guidelines.

‘‘GPs are sandwiched in these situations,’’ said Betty, who thought GPs’ clinical judgments were often not respected and often faced referrals being thrown back by hospitals.

When approached Waikato DHB about why Turner had to wait seven months for screening, it said the patient had ‘‘timely access’’ to procedures and treatment after being accepted to the DHB’s specialist services.

However, it admitted the case ‘‘raised queries’’ about the referral process guidelines, and said it would be sharing those with the Ministry of Health (MOH) to consider whether the criteria may be reviewed.

Waikato DHB spokeswomen Christine Lowry said its referral guidelines were based on MOH guidelines for suspicion of bowel cancer.

She said ‘‘there will always be cases which sit outside those guidelines, and it is an important role for all clinicians to be able to interpret guidelines and communicate any concerns which may sit outside them’’.

The ministry was approached for comment but did not respond before deadline.

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en-nz

2022-01-18T08:00:00.0000000Z

2022-01-18T08:00:00.0000000Z

https://fairfaxmedia.pressreader.com/article/281560884161072

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