Unravelling the barriers to surveillance Colonoscopy in rural Australia: A Comprehensive Retrospective analysis

Author(s): Yasir A Hasan, Zainab Naseem, Chathura Egoda Arachchilage, Kate Fitzgerald, Narayanan Jayachandran, Abrar Maqbool, Warren Hargreaves

Introduction: This study aims to explore the multifaceted causes of delay in surveillance colonoscopy within a rural endoscopy centre in New South Wales (NSW), with a particular focus on the crucial need for adherence to surveillance guidelines within the prescribed time frames.

Methods: A retrospective observational study was conducted, comprising a thorough analysis of hospital records for all patients who were scheduled for surveillance colonoscopy from March 2019 to March 2023. This dataset encompassed a total of 2043 patients.

Main outcome: Of the 2043 patients, 77 experienced a delayed surveillance colonoscopy. An examination of various factors contributing to this delay revealed no statistically significant effects relating to gender, age, or family history in terms of compliance.

Results: The analysis determined a statistically significant impact of the index diagnosis on the delay (p = 0.049), with non-malignant polyps accounting for the longest mean delay (Mean = 15.95, Standard Deviation = 9.90). Primary causes of delay were attributed to the COVID-19 pandemic (35%) and logistical challenges (23%).

Conclusion: This investigation illuminates specific factors influencing delays in surveillance colonoscopy, with particular emphasis on index diagnosis and exogenous factors such as the pandemic. The insights garnered from this study can serve as an essential resource for healthcare providers, enabling them to devise strategies that facilitate timelier adherence to surveillance colonoscopy guidelines. Such interventions could substantially enhance patient care in rural healthcare environments.