Vernon leads the world when it comes to people arriving at the emergency room in pain and not knowing they have cancer.
A recent study indicates that of 75 patients requiring colorectal cancer treatment between April 2009 and March 2010, 43 per cent showed up at Vernon Jubilee Hospital on an emergency basis for bowel obstruction, hemorrhages and perforations. They were first diagnosed with cancer while in the ER.
“It’s very, very high. It ranges from six to 36 per cent (elsewhere),” said Dr. Hamish Hwang, a local surgeon who authored the study, which was published in the B.C. Medical Journal.
“It’s the highest published data in the world.”
He became intrigued with the topic after moving to Vernon six years ago.
“I would see one of these patients about once a month. It’s unusual because I didn’t see it as often in Vancouver.”
Hwang believes there may be a high number of colorectal cancer cases because of the region’s elderly population.
Many aren’t being diagnosed early possibly because they don’t have a family doctor or they aren’t accessing health care services.
“People, for some reason, are not going to see the doctor,” he said.
Hwang also expects some people avoid screening because the colon is involved.
“People are embarrassed but they shouldn’t be.”
Not being aware of the situation until a patient arrives in ER makes it more challenging for doctors if the cancer has spread.
There is also pressure on limited space in the hospital.
“The ones that come in emergency on average stay 24 days in the hospital, twice as long as non-emergency cases,” said Hwang.
“When the hospital is at capacity, this is a huge burden.”
Colorectal cancer is the second most common cancer in men and the third most in women. It is the leading cause of cancer death in non-smokers.
Hwang is calling on the provincial government to initiate a colorectal screening program, something that currently doesn’t exist.
“For countries with screening, emergency rates are lower. Italy is six per cent,” said Hwang.
“There’s no checks and balances for these people.”
Hwang is also putting the onus on residents to become active in preventing the disease.
“People need to take charge of their health,” he said.
Hwang recommends colonoscopies for people with a family history of colon cancer and fecal occult blood tests or fecal immunochemical tests for anyone over age 50 (not covered by the Medical Services Plan).
Hwang believes lessons can be learned from VJH as B.C.’s population continues to age.
“Vernon is a crystal ball for the whole province. What’s happening in Vernon will be the whole province in 25 years,” he said of 22 per cent of the city’s total population being more than 65 years old.
“Now is the time to be doing something. I hope this study is a wake-up call for the government and the public.”
