Colonic Polyp Surveillance

Availability

North South North West Statewide

Pre-referral work-up

History

All referrals should comply to referral standards and include in particular:

Initial work up:

Provide details of:

  • Last colonoscopy report and histology (if possible or date and site of examination)
  • Family history including:
    • Family member's relationship to patient
    • Family member's age at diagnosis of colorectal cancer (CRC) or polyps
    • Any family history of uterine, ovarian, gastric or small intestinal tumour
  • Medications especially anticoagulants and reason for prescription, iron, NSAIDs, steroids and hypoglycaemic agents.
  • History of cardiovascular disease, renal disease, liver disease, diabetes .

Based on the published NHMRC guidelines for polyp follow-up.

Interim/GP management

To refer a patient with this condition, please see the Gastroenterology clinic page for the full referral process and templates.

All patients referred for surveillance colonoscopies after removal of polyps or for family history are triaged according to the following guidelines:

For more information please see the Tasmanian Health Pathways website.

Semi-urgent / category 2

Refer for repeat colonoscopy 3 months after previous colonoscopy if:

  • Piecemeal removal, or excision of malignant adenoma OR
  • Incomplete excision of a large adenoma

Routine / category 3

Refer for repeat colonoscopy within a year if:

Incomplete or inadequate examination

  • e.g. Multiple adenomas

Refer for repeat colonoscopy within 3 years for:

  • Large adenomas (> 1 cm)
  • High-grade dysplasia
  • Villous change
  • Three or more adenomas

Refer for repeat colonoscopy within 4–6 years for:

  • Those without the preceding risk factors for colorectal cancer

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

GESA Guideline: Bowel Cancer – Early Detection, Screening and Surveillance

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED – Phone: (03) 6493 6340  Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6173 0489

Urgent:

We will endeavour to see these patients within four weeks

Urgent referrals should be accompanied by a phone call to the clinic and the relevant doctor for urgent assessment, or patient should be directed immediately to the Emergency Department.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment