Manitoba 'late to the game' in adding colon cancer test that could reduce endoscopy waitlists
CBC
A gastrointestinal expert is encouraged Manitoba is taking steps to catch up with other provinces by offering a less invasive form of colorectal cancer screening, but he's skeptical the test will help much in chipping away at the province's significant waitlist for colonoscopies.
Last week, the provincial surgery backlog task force announced Manitoba will begin performing fecal immunochemical testing (FIT) as a way of reducing the need for endoscopies, which includes colonoscopies.
Using FIT broadly might lead to quicker screenings and free up operating room spaces for other procedures, according to the task force.
Dr. Charles Bernstein, a gastroenterology expert, says Manitoba is the last province to begin using FIT.
"We are late to the game in Manitoba," said Bernstein, distinguished professor of medicine at the Max Rady College of Medicine at the University of Manitoba.
Up to now, Manitoba has been using what's known as guaiac testing, in addition to colonoscopies, to screen for and treat pre-cancerous and cancerous polyps and lesions in the colon.
Guaiac tests screen for the presence of blood in a patient's stool, but the test has limitations, Bernstein says. In order to be most accurate, it must be done on a day when a lesion or polyp in the colon is bleeding.
That can lead to a false negative that suggests there are no problem polyps when in fact they might have simply evaded detection.
FIT-based tests are "much better" than guaiac — about 75 to 80 per cent accurate at detecting the presence of lesions or polyps, Bernstein says. They're even more accurate at detecting large polyps or cancerous legions.
FIT is also more expensive than guaiac, something Bernstein speculates could have something to do with why Manitoba held off on implementing it sooner.
The province estimates introducing FIT could drop the number of endoscopies needed, including colonoscopies, by 10 to 15 per cent.
Bernstein isn't so sure.
"In terms of the task force and the notion that this can help reduce the vast endoscopy waitlists, I would say that this may put a ding in it as opposed to a dent," Bernstein said.
He estimates there were roughly 1,500 people waiting for endoscopies pre-pandemic. That number has ballooned to about 11,000, Bernstein said.
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