Legislative Council, Wednesday 28 May 2025

Ms FORREST question to ACTING LEADER of the GOVERNMENT in the LEGISLATIVE COUNCIL, Mrs PALMER

With regard to the eligibility of patients aged 45-74 for the National Bowel Screening Program:

1) Acknowledging this is a national scheme facilitated by the Australian Government, what is the rationale for the eligibility for patients being cut off at 74 years of age, given that our population is aging and our life expectancy is increasing?

2) Can patients aged over 74 who require a colonoscopy procedure following screening, either through the National Bowel Screening or occult faecal blood test ordered by a GP where there is an increased risk of harm, access this procedure at a Tasmanian hospital as an urgent procedure;

a. What is the current waiting time for all patients for;
i. Routine screening colonoscopy; and
ii. Urgent colonoscopy related to symptomatic patients or those with positive faecal occult blood tests?

b. Does the age of the patient have any impact on waiting times?

ANSWER:

1. I am advised that the age range for the National Bowel Cancer Screening Program is informed by the National Health and Medical Research Council approved Clinical Practice Guidelines (Clinical Practice Guidelines for the prevention, early detection, and management of colorectal cancer – updated 2023).
These Guidelines indicate that extending the upper limit of the age range from 74 “is not recommended for population screening, because the likely benefits do not outweigh the burden (number of colonoscopies and associated risk), compared with screening for people aged 45–74 years”.

The National Bowel Cancer Screening Program is largely guided by clinical advice and modelling, and is evolving over time. I am advised that any new evidence published to support increasing the upper end of the age bracket would be considered by the National Bowel Screening Program.

People aged 75–85 who have concerns about bowel cancer are encouraged to discuss bowel screening options with their General Practitioner. Should a doctor recommend screening, a Medicare funded kit may be made available, or alternatively, non-program screening kits are available for purchase at pharmacies or online.

2. I am advised that patients aged over 74 who require a colonoscopy procedure following screening, either through the National Bowel Screening or occult faecal blood test ordered by a GP where there is an increased risk of harm, can access this procedure at a Tasmanian hospital as an urgent procedure

a. i. Those awaiting a routine screening colonoscopy are generally Category 3 (non urgent) patients. In the 12 months to April 2025, the median waiting time for all Category 3 (non urgent) patients that were seen was 105 days.

a. ii. Those awaiting an urgent colonoscopy related to symptomatic patients or those with positive faecal occult blood tests are generally Category 1 (urgent) patients. In the 12 months to April 2025, the median waiting time for all Category 1 patients that were seen was 74 days. This is the average, with some patients seen sooner based on clinical need.

b. Patients are categorised and treated based on clinical urgency.
The Tasmanian Government is committed to improving access to endoscopy services, including colonoscopy. In 2023, the Tasmanian Government invested a further $38.75 million over four years for endoscopy services through the Statewide Endoscopy Services Four-Year Plan 2023-2027. This plan includes a range of actions and initiatives to increase the number of people seen within clinically appropriate times.