Only 13.9% of Australians with a positive bowel cancer screening result get a colonoscopy within the recommended 30 days.1 Most wait a lot longer than that. The reason isn’t neglect. It’s capacity.
The wait is a system problem, not a personal one
If you’ve been referred for a colonoscopy and you’re still waiting, here’s something worth knowing: it’s not about you.
Bowel Cancer Australia’s analysis of the latest National Bowel Cancer Screening Program data shows people waited between 129 and 179 days for a colonoscopy in 2023, depending on which state or territory they live in.1 That’s well beyond the 30-day target set for people with a positive result.
Colonoscopy is a limited resource. Demand for it has grown faster than the workforce and facilities that deliver it. Every specialist, every endoscopy suite, every recovery bed is shared across a queue of people — some already screened positive, some referred by a GP for symptoms, some overdue for surveillance after a previous finding.
A long wait reflects national capacity. It doesn’t reflect how urgent your case is.
This matters because waiting is stressful, and stress makes people assume the worst. It’s a natural reaction. But a slow-moving queue is a system-wide issue, not a signal about what’s happening in your body.
GPs are triaging under real pressure
If you’re a GP, none of this is news. You’re the one deciding who goes on the list, and how urgently.
That decision is harder than it sounds. Bowel symptoms — abdominal pain, altered bowel habit, rectal bleeding — are common, and most people who have them don’t have bowel cancer. But some do. Sorting genuinely urgent cases from the rest, with limited time and limited tools, is the daily reality of referring into an overloaded system.
Every referral competes for the same finite pool of colonoscopy slots. Categorising a patient as urgent doesn’t create more capacity — it just moves someone else further back in the queue. That’s the tension GPs manage every time they write a referral: being fair to the patient in front of them, and to everyone else waiting behind.
More referrals don’t fix this. Better information at the point of referral does.
Triage tools are entering the pathway
A new category of tools is emerging to help with exactly this problem: blood-based tests designed to sit alongside existing pathways, not replace them, and give GPs more information before a patient reaches the specialist.
These tools help decide who needs a scope, and who gets scoped first.
ColoSTAT® is one of them.
ColoSTAT® is a new option now available in Australia — a blood-based test developed from CSIRO research, with NATA accreditation. It’s intended for people aged 45–84 with symptoms of bowel cancer who are being assessed by a GP. ColoSTAT® is not a replacement for colonoscopy, but it can help GPs decide who needs to be prioritised. A negative ColoSTAT® result carries a 99.4% negative predictive value — meaning if the result comes back negative, statistically there is less than a 1% chance the patient has bowel cancer.2 For both doctors and patients, this kind of additional information can be genuinely useful, and reassuring.
For GPs, there’s a practical workflow benefit worth naming directly. ColoSTAT® can be ordered at the same time as other blood tests and the specialist referral — not instead of it. That means the gastroenterologist can receive the referral and the ColoSTAT® result together, rather than the result arriving separately or after the fact. Less back-and-forth. Less duplicated triage. A clearer picture, sooner, for the clinician deciding what happens next.
There’s also a longer-term premise behind triage testing like this, worth naming plainly. The immediate value is helping decide who gets scoped first. Over time, the same mechanism has a broader role: giving GPs a safe, evidence-based basis to manage some patients without an urgent colonoscopy referral at all right now — choosing to monitor or reassess, rather than investigate immediately. ColoSTAT® is not a replacement for colonoscopy, and any patient with a concerning symptom picture still needs one. But a high-confidence negative result is something a GP can act on today, not months into a wait. That’s the real premise of a triage test: not just reordering pressure on the system, but reducing it.
What this means, practically
For patients, the takeaway is simple: a wait doesn’t mean something is wrong, and a referral is a routine part of a stretched system doing its job carefully. If a blood-based option like this is relevant to your situation, it’s worth asking your GP.
For GPs, the takeaway is also simple: the bottleneck is real, and it’s not going to be solved by volume alone. Every year the system asks for more colonoscopy slots, more specialists, more theatre time. All of that helps. None of it is quick. Tools that improve triage now — using information that’s already available at the point of referral — are a faster lever to pull while capacity catches up.
In the most recent AIHW monitoring report, only around 1 in 29 people who followed up a positive bowel screening result with a colonoscopy were diagnosed with a confirmed or suspected cancer. That translates to well over 90% were not.3 And it remains true whether the wait is short or long. But for the people who do need to be seen first, having a way to identify them earlier matters — for patients, and for a system under pressure.
Sources
- Bowel Cancer Australia, analysis of the AIHW National Bowel Cancer Screening Program (NBCSP) Monitoring Report, 2023 data — colonoscopy wait times and 30-day target compliance (bowelcanceraustralia.org).
- Nair et al., Under Review, 2026
- AIHW, National Bowel Cancer Screening Program Monitoring Report 2026 (aihw.gov.au) — proportion of colonoscopies following a positive screen that detected a confirmed or suspected cancer, 2024 data. Note: this figure describes the NBCSP screening-positive cohort specifically, not GP referrals for symptomatic patients generally.
