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Colorectal cancer screening

Summary of recommendations for colorectal cancer screening and surveillance in high risk groups

British Society of Gastroenterology Guidelines 2010

colorectal cancer screening

British Society of Gastroenterology guidelines for follow up after resection of colorectal cancer

  • It is reasonable to offer CT imaging of the liver to asymptomatic patients within 2 years after potentially curative resection.
  • Although there is no evidence that colonoscopic follow-up improves survival, it does yield some treatable tumours. It is recommended that a colonoscopy is done 5 years after surgery and thereafter ever y 5 years until the benefit is outweighed by co -morbidity. Patients found to have adenomas at the time of diagnosis of colorectal cancer or on follow-up surveillance should follow adenoma surveillance guidance, continuing surveillance at least 5-yearly until benefit is outweighed by co morbidity.

British Society of Gastroenterology guidelines for colorectal cancer screening and surveillance in moderate risk family groups

Moderate risk family history categories Life time risk of CRC death without surveillance First screening colonoscopy Screening interval
CRC in 3 FDR in first degree kinship, none < 50 yrs 1 in 6-10 50 yrs 5 yrly to age 75 yrs
CRC in 2 FDR in first degree kinship, mean age <60 yrs 1 in 6-10 50 yrs 5 yrly to age 75 yrs
CRC in 2 FDR >= 60 yrs 1 in 12 55 yrs Once only colonoscopy at age 55 yrs.
CRC in 1 FDR < 50 yrs 1 in 12 55ys Once only colonoscopy at age 55 yrs.
All other FH of CRC (see note below) >1 in 12 None NA

First degree kinship: Affected relatives who are first-degree relatives of each other AND at least one is a first degree relative of the consultand.

NB- All other FH of CRC: should be reassured and encouraged to avail themselves of population-based screening measures. The low level residual risk over that of the general population should be explained. Furthermore, because the population lifetime risk in the UK is around 1:20, some people without any family history will develop colorectal cancer, and this residual population risk should be made explicit.

American Gastroenterological Association (page 24)


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