In the midst of a new outbreak of Covid-19 in New South Wales, it is apt that this edition of Healthcare Spaces focuses on cancer. It is not just elective surgery that is being cancelled due to Covid-19; delays and restrictions during the pandemic also continue to cause disruption to cancer services including screening, diagnosis and treatment.

September’s instalment of the newsletter covers a range of topics related to cancer care, including the impact of waiting on patients’ physical and mental health, the importance of communication on improving services to patients, and data showing the impact of Covid-19 on cancer services. One of the articles also looks at ways to increase access to diagnostic services for Australia’s remote and indigenous communities.

Resilience is a key topic. Despite the knowledge and experience we now have about treating patients during a pandemic, services are still disrupted during outbreaks, causing backlogs and delays to patients’ care. It is vital to increase resilience and improve patient flows during critical times, and adding flexible capacity can help hospitals cope better with changing demand or uneven pressure on the existing hospital estate.

The issue of bowel cancer is an important one. Research has established that delays to screening, diagnostic and surveillance colonoscopies increase the risk for bowel cancer progression and mortality. Early diagnosis is a key predictor of surviving bowel cancer, and positive test results and symptoms need to be investigated via timely colonoscopy, but with endoscopy activity impacted by the pandemic we are likely to see negative outcomes going forward.

It is now more likely that patients will present with more advanced disease, require more complex treatments and experience poorer outcomes. What is also concerning is that the number of younger Australians – the under 50s – diagnosed with bowel cancer has been increasing steadily. The 45-49 cohort is also seeing an increase in mortality rates, and it is the deadliest cancer in the age group 25-34.

Planning for post-Covid-19 colonoscopy catch-up and ongoing capacity is urgently required to ensure bowel cancer doesn’t become the forgotten ‘C’ in the long shadow of Covid-19.



Julien Wiggins

CEO, Bowel Cancer Australia
Guest Editor, Healthcare Spaces Q3 2021