2.1 Colonoscopy hospitalisations, all ages

The Atlas found the rate of hospitalisation for inpatient colonoscopy varied up to about seven-fold between local areas across Australia, in 2016-17. The rate of hospitalisations for colonoscopy for Aboriginal and Torres Strait Islander Australians was 47% lower than the rate for other Australians.

Triaging systems, already in place in some states, could be more widely used in Australia to prioritise colonoscopy for patients who are most at risk of bowel cancer, and to reduce inappropriate use for primary screening and unnecessary repeat colonoscopies. Lower participation in the National Bowel Cancer Screening Program, as well as poorer access to colonoscopy, needs to be addressed for Aboriginal and Torres Strait Islander Australians, people at socioeconomic disadvantage and those living outside major cities.

Colonoscopy

2a. State and territory health departments to adopt triaging systems to prioritise colonoscopy for individuals who are most at risk of bowel cancer. Colonoscopy should not be used routinely for primary screening, and timing of repeat surveillance colonoscopies should follow National Health and Medical Research Council guidelines.

2b. Health service organisations to ensure that, in settings where colonoscopy and gastroscopy are provided in the same clinic, patient need and likelihood of benefit of each procedure determine the overall clinical priority.

2c. The National Bowel Cancer Screening Program to develop and test methods to improve uptake by Aboriginal and Torres Strait Islander Australians.

2d. Relevant colleges and clinical societies to review their training programs to incorporate the Colonoscopy Clinical Care Standard and meet the needs of at‑risk groups, including Aboriginal and Torres Strait Islander Australians, people at socioeconomic disadvantage and people living outside major cities.

2e. Health service organisations and facilities providing colonoscopies to monitor adherence to the Colonoscopy Clinical Care Standard to ensure that patients with the greatest need for colonoscopy are prioritised.

Download the colonoscopy hospitalisations section of the Atlas below, to read more about the context, data, key findings, interpretation, and addressing of variation for this clinical item:

Content list:

• Context
  • Why revisit variation in colonoscopy?
• About the data
  • Same-day procedure admission policies
  • Aboriginal and Torres Strait Islander identification
• What do the data show?
  • Magnitude of variation
  • Analysis by remoteness and socioeconomic status
  • Analysis by Aboriginal and Torres Strait Islander status
  • Analysis for people aged 49 years and under
• Interpretation
  • Clinical decision making
  • Access to colonoscopy services
  • Rates of private health insurance
  • Update of bowel cancer screening
  • Other factors
• Addressing variation 
  • Colonoscopy clinical care standard
  • Triage systems
  • Appropriate prioritisation of colonoscopy and gastroscopy
  • Prevention of bowel cancer
  • Aboriginal and Torres Strait Islander Australians and bowel cancer