Authored by the Australian Commission on Safety and Quality in Health Care with medical journalist Nicole MacKee
History repeats: colonoscopy concerns remain
Marked variation raises questions about low-value care
Professor Anne Duggan, the Commission’s Chief Medical Officer
Some people in wealthier urban areas are having colonoscopies too frequently, while others in regional and socioeconomically disadvantaged
The rate in areas with the highest use was almost 20 times the rate in areas with the lowest uptake, with a range from 62 to 1,236 per 100,000 people.
areas are not being tested at the appropriate rate, according to the Australian Commission on Safety
Repeat colonoscopy is used mainly to check for polyps and bowel cancer in people with a higher
and Quality in Health Care’s Fourth Australian Atlas of Healthcare Variation. ‘Where clinicians are not following best practice, they are subjecting people to procedures they
risk of bowel cancer. There are limited reasons why a colonoscopy would be repeated within three years if guidelines are followed. Consumers living in metropolitan areas,
don’t need, while others are not getting the care they do need,’ says Professor Anne Duggan, the
particularly those from high socioeconomic status (SES) areas, have markedly higher rates of repeat
Commission’s Chief Medical Officer. The Fourth Atlas shows that in 2018–19 there were almost 148,000 Medical Benefits Schedule (MBS)-subsidised repeat colonoscopies — defined as a colonoscopy repeated within two years and
colonoscopy than consumers living in rural and remote regions, and those from lower SES areas. The Atlas also highlights differences in uptake between states and territories, with a rate of 596 per 100,000 people in Queensland compared
10 months of a previous procedure — in Australia.
with 191 in the Northern Territory.
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The Health Advocate • MAY 2021
