Radiologists urge Ottawa to act decisively on backlogs

OTTAWA – In response to the backlog in diagnostic tests that has resulted from the COVID-19 pandemic, the Canadian Association of Radiologists (CAR) is urging the federal government take quick action in three areas to reduce wait lists and improve the health and medical outcomes of Canadians. As noted in the organization’s recent report, “Addressing the Medical Imaging Dilemma in Canada: Restoring Timely Access for Patients Post-Pandemic,” the federal government is being asked to:

• Invest $1.5 billion over five years in medical imaging equipment and health human resources to support the increased capacity.
• Support the implementation of a national e-referrals program (Clinical Decision Support) to provide referring health professionals with better access to medical imaging guidelines, ensuring that patients receive the right test at the right time.
• Create a National Data Science Institute to harness AI for the strategic prioritization of health human resources, technology, and infrastructure for medical imaging in the wake of the pandemic and beyond.

According to CAR, COVID-19 postponed medical imaging services in every jurisdiction across Canada. While these services resumed to 75% of capacity, in some cases, the current backlog is insurmountable and lower-priority patients will simply not be seen.

Prior to the pandemic, Canadians were waiting an average of 50 to 82 days for CT scans and 89 days for MRI imaging. This is 20 to 52 days longer than the recommended 30-day wait time.

Due to COVID-19, waitlists are even longer, putting Canada in crisis mode for medical imaging. This is especially concerning for individuals needing breast and colorectal cancer screening, patients undergoing cancer treatment, or those who may need imaging but have delayed seeking care due to fears or factors associated with the pandemic.

With nearly large numbers of Canadians now vaccinated, radiology departments across the country are seeing a massive influx of patients attempting to reschedule their appointments. This is on top of the existing need and extremely lengthy wait lists for imaging in Canada.

“Our healthcare system is not equipped to handle these volumes; we are at risk of leaving many patients undiagnosed and treated,” the report said.

The Canadian Association of Radiologists (CAR) recommends that the Government invest in medical imaging equipment, health human resources, technology infrastructure, and a national Clinical Decision Support framework to meet the needs of patients whose care has been adversely affected by the pandemic. This will help prepare our healthcare system to address the medical imaging challenges now and in the future.

Delays for medical imaging have hindered the detection and management of many diseases including colorectal cancer, a preventable disease that is the third most common cancer and second leading cause of cancer-related death in men, and the third leading cause of cancer-related death in women in Canada.

The pandemic heavily impacted routine endoscopy and colonoscopy screening. Patients who were identified as average risk were offered less effective methods of screening as a replacement to medical imaging.

“In my practice, a 70-year-old man who had two positive fecal tests had appointments for conventional colonoscopy cancelled twice. He subsequently presented for imaging and was found to have a carcinoma in his sigmoid colon at CT. That stage of cancer at time of diagnosis has significant implications not only for immediate treatment options, but also for five-year survival rates and risk of recurrence. Earlier detection through medical imaging would have impacted his diagnosis and prognosis much more favourably. This is just one of many examples have how the pandemic has impacted medical imaging in Canada,” said Dr. Tanya Chawla (pictured), assistant professor, Mount Sinai Hospital, Dept. of Medical Imaging.

The current data suggests that in Ontario it will take 41 months to get back to acceptable wait time unless there is an intervention. This will have a tremendous impact on thousands of patients and their chance of recovery.