My Colonoscopy Experience | What are patient-reported experience measures (PREMs)? | Australians share their colonoscopy experience
A colonoscopy is an invasive procedure that allows for the full examination of the lining of your bowel (colon and rectum).
During the procedure, the colonoscopist spends most of the time looking for changes to the normal landscape of your bowel lining and removes anything that looks suspicious, like growths called polyps, which can lead to bowel cancer, for example.
If you are aged 18-and-over and have had a colonoscopy, we invite you to provide feedback about your experience.
My Colonoscopy Experience is a user-friendly and easy to understand questionnaire that can be completed anonymously in around 10 minutes.
Developed by Bowel Cancer Australia and powered by Pulse Infoframe's secure online platform - healthie, the questions ask about your colonoscopy referral, pre-admission, care and treatment, interaction with staff, discharge from care and any post-procedure issues.
Why?
Every person’s feedback about their colonoscopy experience is unique and valuable.
Your experience with the health system is an important and meaningful measure of quality of care that can be used for performance monitoring purposes and to drive quality improvement.
My Colonoscopy Experience only takes a small amount of time to complete, but it can have a big impact.
Measuring patient colonoscopy experience in Australia is long overdue.
Help us ensure the patient voice is heard, so that future colonoscopy care reflects what patients want and need.
| What are patient-reported experience measures (PREMs)?
Communicating the unique patient perspective is vital for understanding how to make services better and safer for patients.
Healthcare providers need to understand what ‘good care’ means to patients and exactly what patients experience during their care.
By asking patients questions about their experience using a PREMs questionnaire, it is possible to find out what processes are working well and where things need improvement, so that hospitals and healthcare services can fix them.
The My Colonoscopy Experience questionnaire allows you to report what the colonoscopy experience was like for you, as a patient, because as a patient you can see signs of high or poor quality that may not be seen by staff.
What will I be asked to do?
If you are aged 18-and-over and have had a colonoscopy, we invite you to provide feedback about your experience.
The My Colonoscopy Experience questionnaire can be completed using your desktop computer, smartphone or tablet.
User-friendly and easy to understand, it takes around 10 minutes.
The questions ask about your colonoscopy referral, pre-admission, care and treatment, interaction with staff, discharge from care and any post-procedure issues.
All responses are completely anonymous to ensure no one can be identified.
However, the option is available to include your contact information at the end of the questionnaire if you would like to share additional details about your colonoscopy experience or would like for a Bowel Cancer Australia team member to get in touch with you.
*Ghanouni, A; Plumb, A; Hewitson, P; Nickerson, C; Rees, CJ; von Wagner, C; (2016) Patients' experience of colonoscopy in the English Bowel Cancer Screening Programme. Endoscopy, 48 (3) pp. 232-240.
How will my feedback be used?
Your feedback ensures that the patient’s voice is heard.
With your help we can make real change happen by highlighting what Australians value most – before, during and following a colonoscopy – from a Colonoscopist’s communication skills to their technical ability and their control of discomfort during the procedure.
What else can I do?
You can help us amplify the patient’s voice by sharing the My Colonoscopy Experience questionnaire with anyone you know who has received a colonoscopy in Australia.
What if I have more questions?
If you have questions or would like to know more, contact our Helpline on 1800 555 494 during business hours, or send us an email.
| Australian's share their colonoscopy experience
In 2019, Bowel Cancer Australia released initial findings from the first national My Colonoscopy Experience questionnaire.
The questionnaire opened in September 2018 at the same time as the Colonoscopy Clinical Care Standard, created by the Australian Commission on Safety and Quality in Health Care (ACSQHC).
While the Standard was a welcome first step in outlining the care people who have a colonoscopy should receive, it did not contain specific indicators to measure the patient’s experience.
“Communicating the unique patient perspective is vital for understanding how to make services better and safer for patients,” said Bowel Cancer Australia CEO Julien Wiggins.
“As more and more people share their experience, findings will help shape Bowel Cancer Australia’s initiatives and can be used more broadly as a valuable resource to inform policy, programs, and investment in colonoscopy quality and care,” Mr Wiggins said.
The responses from approximately 1,500 women and men across the country ranging in age from 18 to over 75 years old, who had recently undergone colonoscopy provide unique insights not previously reported.
Some of the better aspects of the colonoscopy experience highlighted by respondents included:
- clear information about what to expect at each stage;
- provision of guidance regarding the post-procedure process; and
- feelings of trust and confidence in staff.
Areas for improvement highlighted by respondents indicated:
- the referral process should be more proactive and timelier;
- more choice should be made available in terms of bowel prep; and
- all relevant information in the colonoscopy report should be reviewed with the patient.
Nine in ten respondents (94%) said a wait time of “less than 1 month” is about right, but most respondents (59%) waited more than the recommended 30 days from referral before receiving their colonoscopy.
Three in ten (32%) respondents indicated they waited more than two months; nearly one in ten of those (7%) reported waiting six months or more.
Respondents receiving their colonoscopy within the public health system reported waiting on average 2.5 months (150% longer than recommended by the World Health Organisation).
"Proactive and timely referral is imperative, especially for symptomatic patients and is something that Bowel Cancer Australia continues to actively campaign for," Mr Wiggins said.
Bowel preparation required for colonoscopy was cited regularly as the key area for improvement.
When asked what could have made the experience better, most respondents’ comments (41%) related to improving the bowel prep experience.
Nearly all respondents (97%) felt information about how to prepare for their colonoscopy was clear; however, most respondents (83%) were not offered a choice regarding the type of bowel prep medicine given.
Two in five (41%) respondents mentioned they would have liked more options.
Private hospital patients rated their experiences more positively than public hospital patients throughout the process, but both private and public hospital patients indicated the best part of their colonoscopy experience was positive interactions with staff (36%).
“With 1.1 million colonoscopies to be performed in Australia in 2020-21, the My Colonoscopy Experience questionnaire will remain open indefinitely – because every patient’s feedback about their colonoscopy experience is unique and valuable.
To share your experience, visit mycolonoscopyexperience.org.
For more information, download the report.
BowelScreen Australia was launched nationally in 2010 as a collaboration between Bowel Cancer Australia and The Pharmacy Guild of Australia to provide greater access to bowel cancer screening through community pharmacies.
BowelScreen Australia uses a clinically proven, sensitive and reliable faecal immunochemical test (FIT).
The Australian designed and manufactured test and accredited pathology services are provided by Clinical Genomics.
The test comes complete with full instructions, a dedicated customer helpline, as well as a reminder service.
No faecal handling, diet or medication changes are required to perform the test, which can be completed in the privacy of your own home.
The recommended retail price of the BowelScreen Australia ColoVantage test is $45 (inc. GST), which includes the test kit, pathology analysis, result reporting to the participant and their nominated GP as well as return postage.
Talk to your GP or pharmacist today about BowelScreen Australia.
Order a screening test online or by calling 1800 555 494.
| How to screen
Brush the surface of your poo for about five seconds on two separate occasions
SAMPLE 1 - Your first poo
STEP 1
- Take the instructions, your information sheet, with the barcode labels, brush kit and test card into the bathroom.
- Flush toilet BEFORE your bowel movement.
STEP 2
- After your bowel movement, DO NOT PLACE USED TOILET PAPER IN THE TOILET BOWL. Instead, put the used toilet paper in one of the blue waste bags from the brush kit envelope.
- DO NOT FLUSH the toilet.
STEP 3
- Lift the flap marked 'LIFT HERE FOR SAMPLE 1' on the test card to uncover the small white square marked 'SAMPLE 1'.
STEP 4
- Using one of the blue brushes, gently brush the surface of the poo for about five seconds.
- If the poo is loose, simply stir the water around the poo.
- Remove the brush from the water and gently shake it once to remove excess water and any clumps of poo.
STEP 5
- Transfer the water sample by gently dabbing the bristles of the brush onto the small white square on the test card for about five seconds (some staining of the square may occur).
- Put the used brush in the blue waste bag and put the bag in your rubbish bin.
STEP 6
- Close the flap back over 'SAMPLE 1' and stick the flap down using one of the barcode labels located on the information sheet.
- See diagrams above for the correct way to position the label.
SAMPLE 2 - Your second poo
This sample must be from a different poo to increase the chance of detecting non-visible blood.
STEP 7
- Use the second blue brush, blue waste bag and the test card flap marked 'SAMPLE 2', and repeat steps 1 to 5 above.
- Use the second barcode label to reseal flap marked 'SAMPLE 2'.
STEP 8
- Complete the information sheet.
- You must complete your GP's details or the test cannot be processed.
- Place the test card and information sheet in the reply paid envelope.
STEP 9
- Mail the envelope so it is received by the laboratory for analysis within 14 days of the date you collected SAMPLE 1.
- Your results will be mailed to you and your nominated GP.
| Become a stockist
Community pharmacies or General Practices interested in stocking
BowelScreen Australia ColoVantage test kits, please call Clinical Genomics on 1800 55 65 75
during business hours and select Option 3 when prompted.
{grebox}For enquiries about BowelScreen Aotearoa test results, please contact Clinical Genomics on +61 2 9887 5300 or email This email address is being protected from spambots. You need JavaScript enabled to view it.{/grebox}
BowelScreen Aotearoa is a collaboration between Bowel Cancer Australia, Bowel Cancer New Zealand and Green Cross Health to provide greater access to bowel cancer screening throughout New Zealand.
BowelScreen Aotearoa uses a clinically proven, sensitive and reliable faecal immunochemical test (FIT).
The Australian designed and manufactured test and accredited pathology services are provided by Clinical Genomics.
The test comes complete with full instructions, a dedicated customer helpline, as well as a reminder service.
No faecal handling, diet or medication changes are required to perform the test, which can be completed in the privacy of your own home.
The recommended retail price of the BowelScreen Aotearoa ColoVantage test is $63 (inc. GST), which includes the test kit, pathology analysis, result reporting to the participant and their nominated GP as well as return postage.
Talk to your pharmacist today about BowelScreen Aotearoa.
Find your nearest Life or Unichem pharmacy or order a screening test online.
For further information, please call 0800 849 104.
Please note: The New Zealand Government is phasing in a National Bowel Screening Program to be completed by 2021. New Zealander’s aged 60 to 74 years who are eligible to for publicly funded health care will receive an invitation to participate in the screening program when it becomes available in their DHB.
Eligible New Zealanders will receive a free faecal immunochemical test (FIT) in the mail and are encouraged to complete and return it. For information regarding start dates of each phase please visit the NBSP website or call 0800 924 432.
| How to screen
Brush the surface of your poo for about five seconds on two separate occasions
SAMPLE 1 - Your first poo
STEP 1
- Take the instructions, your information sheet, with the barcode labels, brush kit and test card into the bathroom.
- Flush toilet BEFORE your bowel movement.
STEP 2
- After your bowel movement, DO NOT PLACE USED TOILET PAPER IN THE TOILET BOWL. Instead, put the used toilet paper in one of the blue waste bags from the brush kit envelope.
- DO NOT FLUSH the toilet.
STEP 3
- Lift the flap marked 'LIFT HERE FOR SAMPLE 1' on the test card to uncover the small white square marked 'SAMPLE 1'.
STEP 4
- Using one of the blue brushes, gently brush the surface of the poo for about five seconds.
- If the poo is loose, simply stir the water around the poo.
- Remove the brush from the water and gently shake it once to remove excess water and any clumps of poo.
STEP 5
- Transfer the water sample by gently dabbing the bristles of the brush onto the small white square on the test card for about five seconds (some staining of the square may occur).
- Put the used brush in the blue waste bag and put the bag in your rubbish bin.
STEP 6
- Close the flap back over 'SAMPLE 1' and stick the flap down using one of the barcode labels located on the information sheet.
- See diagrams above for the correct way to position the label.
SAMPLE 2 - Your second poo
This sampe must be from a different poo to increase the chance of detecting non-visible blood.
STEP 7
- Use the second blue brush, blue waste bag and the test card flap marked 'SAMPLE 2', and repeat steps 1 to 5 above.
- Use the second barcode label to reseal flap marked 'SAMPLE 2'.
STEP 8
- Complete the information sheet.
- You must complete your GP's details or the test cannot be processed.
- Place the test card and information sheet in the reply paid envelope.
STEP 9
- Mail the envelope so it is received by the laboratory for analysis within 14 days of the date you collected SAMPLE 1.
- Your results will be mailed to you and your nominated GP.
The Australian Government introduced the National Bowel Cancer Screening Program (NBCSP) to reduce the number of deaths from bowel cancer in Australia. People with cancers diagnosed through the Program had a 40% lower risk of dying than people who had not been screened.
Eligible people aged 50-74 will receive a tax-payer funded faecal immunochemical test (FIT) in the mail and asked to take two separate poo samples before sending the completed test back to the laboratory for analysis. Click here to check your eligibility.
For further information about the NBCSP please call their contact centre on 1800 627 701 or you can get in touch via the Program's website.
If you are ineligible to participate in the Program, talk to your GP or pharmacist about how to purchase a BowelScreen Australia ColoVantage test. Alternatively purchase a screening test from Bowel Cancer Australia online or by calling 1800 555 494.
| It's Crunch Time campaign
Bowel Cancer Australia was represented on the Australian Government's National Bowel Cancer Screening Program Advisory Group and Communications Working Group, which focused on the roll out of the Program and the development of a national communications framework.
In 2006, the then Minister for Health, the Hon Tony Abbott MP, announced funding for Bowel Cancer Australia to roll-out the first ever national campaign to promote participation by eligible Australians in Phase I and II of the National Bowel Cancer Screening Program.
The It's Crunch Time campaign featured Australian Test cricketer and commentator, the late Max Walker AM.
In the 2014 Federal Budget, the Coalition Government announced an additional $95.9 million over four years to accelerate implementation of the National Bowel Cancer Screening Program to all Australians aged 50 to 74 years by 2020 as the previous Labor Government had only committed to full implementation by 2034.
Wait-time and performance guarantee | National healthcare agreement | House of representatives: E-petition | Further developments
{grebox}
Bowel Cancer Australia advocates for a colonoscopy wait-time and performance guarantee:
- A colonoscopy within 30 days from first healthcare presentation for people experiencing symptoms suggestive of bowel cancer or a positive screen. If wait-times exceed 120 days, a prognosis can worsen if cancer is present.
- Transparency and public reporting of colonoscopy wait-times by all public and private healthcare facilities, released quarterly;
- Adequate funding for colonoscopy services across Australia;
- Collection of patient-reported experience measures within 30 days via a questionnaire from all people who undergo a colonoscopy, asking them about their pre-procedure experience (whether people understood the risks/benefits), the hospital experience (the procedure itself, issues of dignity/privacy); and post-procedure complications (bleeding/pain), with results publicly reported;
- Minimum quality standards and key performance indicators (KPIs) for the delivery of colonoscopy within Australia, along with recording and public reporting of performance against the standards and KPIs.{/grebox}
| A colonoscopy wait-time and performance guarantee
A guarantee - with recording, reporting and resourcing - to address delays in diagnosis
Bowel Cancer Australia is calling on Federal, State and Territory Governments to commit to a national Colonoscopy Wait-time and Performance Guarantee – with recording, reporting and resourcing - to address delays in diagnosing Australia’s second biggest cancer killer.
“It is unacceptable that people with a positive screen or bowel cancer symptoms have to wait six months or longer for a colonoscopy to learn if they have cancer,” said Bowel Cancer Australia Chief Executive, Julien Wiggins.
“During a colonoscopy, pre-cancerous polyps can be detected and removed before they develop into something more sinister requiring surgery and treatment,” said colorectal surgeon, Graham Newstead AM.
“If bowel cancer is detected, and it is still in the earliest stages, almost 99% of cases can be successfully treated,” he added.
Bowel Cancer Australia has long advocated for referral to colonoscopy within 30 days to minimise patient stress and anxiety, as recommended in the Optimal Care Pathway for people with bowel cancer.
Newly released medical guidelines, however are now recommending patients be referred to colonoscopy within a 120-day threshold.
“Despite extending the recommended timeline-to-diagnosis by 300%, the new timeframes are still not being met,” said Mr Wiggins, who shares concerns expressed by individuals involved in developing the new guidelines, that the extended threshold de-emphasises the need for prompt evaluation.
Research shows diagnostic intervals exceeding 120 days are associated with poorer outcomes, yet the number of days 90% of National Bowel Cancer Screening Program (NBCSP) participants with a positive screen are waiting range between 116-181 days, depending on where they live in the country.
“What is needed is a Colonoscopy Wait-time Guarantee,” said Mr Wiggins, “complete with public wait-time recording, reporting and adequate resourcing of colonoscopy.”
“Publishing wait-times will highlight where resources need to be allocated to improve patient care and will demonstrate a clear commitment on the part of government to meet their own endorsed colonoscopy wait-time recommendations,” said Mr Wiggins.
The National Healthcare Agreement affirms all governments agree that Australia’s health system should, among other things, provide every Australian with timely access to quality health services based on their need, not their ability to pay, regardless of where in Australia they live.
In the lead up to September 2018, the Council of Australian Governments (COAG) is considering a longer-term public hospital funding agreement.
The Agreement will establish a list of commitments which includes public hospital funding, as well as public and private hospital-performance reporting.
The new Agreement commenced on 1 July 2020 – the same year that full implementation of the National Bowel Cancer Screening Program occured and demand for colonoscopies is projected to reach 1.11 million.
In February 2018, Bowel Cancer Australia encouraged Australians to sign the e-petition calling on the House of Representatives to ensure people with bowel cancer symptoms or a positive screen, receive a colonoscopy with a maximum wait time of 120 days, no matter where in Australia they live.
Timely access to a colonoscopy is essential to reduce bowel cancer deaths and minimise distress and anxiety in people experiencing symptoms or those with a positive screen awaiting investigation.
Thank you to everyone who signed the e-petition. The signing deadline has now passed with over 3,500 signatures collected during the 28-day period.
Tasmania
In February 2023, the Tasmanian Premier announced $38 million in funding to deliver an additional 22,000 endoscopies over the next four years with the aim of driving down waiting lists to a sustainable level of 2,500 people at any one time by June 2027.
In August 2021, the Tasmanian Budget delivered additional funding for elective surgery. As part of a $40 million top up, funding for an additional 7,000 elective surgeries was promised, on top of funding committed to at the State Election for an extra 22,300 surgeries and endoscopies.
On 10 April 2019, the Prime Minister Scott Morrison announced the Government would invest $34.7 million to reduce waiting times by providing an additional 6,000 surgeries and endoscopies and for primary care support for Tasmanians in rural and remote locations through TazReach.
Nationwide
On 9 April 2019, the Opposition Leader Bill Shorten promised to invest $500 million to reduce waiting times for cancer treatment and surgery in public hospitals across Australia if elected. Mr Shorten cited official data, stating 83 per cent of people who received a positive-test result from the government's bowel cancer screening program did not have a follow-up colonoscopy within the recommended time.
E-petition
The Colonoscopy Wait-time Guarantee e-petition was presented to the House of Representatives on 21 May 2018 and was referred to the Minister for Health.
The Minister's response stated that the 'Government will work with state and territories to develop an action plan that reflects their respective roles in ensuring capacity can meet the demand for colonoscopy services into the future, beyond the small percentage generated by the National Bowel Cancer Screening Program'.
The response concluded by stating 'while colonoscopy performance measures are not reported at a national level, the AIHW publishes annual monitoring reports against NBCSP key performance indicators, including waiting times and adverse events following colonoscopy. The AIHW will also be tasked with including a 120-day reporting timeframe for waiting times to colonoscopy in future reports'.
2018-19 Federal Budget
The 2018-19 Federal Budget provided $35 million over four years for a national partnership with State and Territory governments to fund the follow-up of people who have received a positive at-home bowel cancer screening test result and are not recorded as having attended a follow-up appointment with a health professional.
Council of Australian Government (COAG) Health Council
The federal, state and territory Health Ministers met in Sydney on 13 April 2018 at the COAG Health Council to discuss a range of national health issues.
Major items discussed by Health Ministers included, among other things, the impact of the National Bowel Cancer Screening Program expansion on colonoscopy demand and waiting times.
A key impact of the Program and its expansion is the increased volume of people requiring diagnostic assessment through colonoscopy.
Health Ministers agreed that the Commonwealth and states and territories should work together to ensure that future infrastructure and workforce capacity and development are better matched to the expected increase in demand.
Victoria
On 1 April 2018, the Victorian Labor Government announced a $12 million injection into Victorian hospitals to fast-track access and cut waiting times for colonoscopy procedures.
This will provide colonoscopies for 6,635 patients across Victoria who are in the most urgent category and who have been waiting the longest.
From 1 July 2018, new Colonoscopy Guidelines for Victorian Patients will come into force, with a target to ensure all Victorians patients in urgent need of colonoscopy receive them within 30 days.
According to media reports, the Victorian Government is calling for a united approach to mounting colonoscopy waiting lists. The Victorian Premier wants Canberra to increase infrastructure and the workforce to perform colonoscopies. The Victorian Government is also calling on states to develop uniform reporting to ensure colonoscopies are completed within the 120-day guideline as well as assurances category 1 patients with be seen within 30 days of a referral.
South Australia
The South Australian Government committed $5 million to a Bowel Cancer Prevention Initiative to:
- Eradicate, within 12 months of the election (17 March 2018), the overdue waiting list for colonoscopy after a positive bowel cancer screening test result;
- Regularly publish the number and waiting times of people requiring a colonoscopy after a positive bowel cancer screening test result;
- Pursue the national time target for a colonoscopy after a positive bowel cancer screening test result.
On 31 August 2018, the South Australian Government announced a $45 million investment to significantly reduce the number of overdue elective surgery patients in South Australia, including patients waiting beyond recommended clinical time frames for colonoscopy procedures.
There are around 4,100 South Australians who have been waiting for a colonoscopy beyond recommended clinical time frames.
According to the Premier's media release, 'the Government's $5 million commitment towards additional colonoscopies will see SA Health work with the private sector to carry out an extra 2,700 colonoscopies over the next nine months, the remaining overdue colonoscopies will be funded with Elective Surgery Funds. This is in addition to the approximately 25,000 colonoscopies carried out in the SA public health system each year'.
