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Safer Care Victoria’s Best Care resources support patients and healthcare providers to have conversations and make decisions together about the most appropriate pathways for care.

This resource, developed for clinicians, details a specific elective surgery procedure that should now only be done for specific indications. Evidence-based recommendations that detail ‘best care’ pathways should be discussed with your patient to determine the most appropriate pathway of care.

Advice

For an average-risk person, a surveillance colonoscopy should only be repeated every five years unless new symptoms emerge in that interval.

An average-risk person is someone who has had one or two small (less than 1cm) adenomas with no villous features and no high-grade dysplasia removed via high-grade colonoscopy.

This advice is consistent with the Cancer Council Australia guidelines endorsed by the National Health and Medical Research Council (NHMRC).

When is the procedure indicated?

The Cancer Council Australia guidelines identify exceptions to the advice.

For example, a person is considered at higher risk if they have had three to four adenomas - with at least one adenoma greater than 1 cm - with villous features or high-grade dysplasia removed via high-grade colonoscopy. People at a higher risk should have a surveillance colonoscopy at more frequent intervals as outlined in the NHMRC-endorsed guidelines.

A change in bowel habit for six weeks or longer indicates the need for a surveillance colonoscopy.

Best care recommendations

Surveillance colonoscopy should be undertaken at intervals as described in the NHMRC-endorsed guidelines. A faecal occult blood test should be used as an interim screening measure.

Evidence

Cancer Council Australia Colorectal Cancer Guidelines Working Party. Clinical practice guidelines for surveillance colonoscopy [Internet]. Melbourne (VIC): Cancer Council Australia; 2017 [cited 2020 June 13].

Cancer Council Australia Colorectal Cancer Guidelines Working Party. Clinical practice guidelines for the prevention, early detection and management of colorectal cancer [Internet]. Melbourne (VIC): Cancer Council Australia; 2017 [cited 2020 June 13].

Department of Health and Human Services. Specialist clinics resources: The Victorian Endoscopy Categorisation Decision Support Tool [Internet]. Melbourne (VIC): Department of Health and Human Services; 2017 [cited 2020 Nov 20].

Page last updated: 08 Feb 2021

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