Upper GI | Colonoscopy | Endoscopic Ultrasound
Direct Access Endoscopy – Clinical Indications update (March 2020)
Initial Endoscopy |
Repeat Endoscopy |
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Individuals who have one first degree relative diagnosed with colorectal cancer before age 60 years. Benefit will be provided for colonoscopy from age 40 years, or 10 years before the age at diagnosis of the youngest affected relative, whichever is the first, and, if normal, repeats at five-yearly interval.
Individuals with one first degree relative diagnosed with an advanced adenoma before age 60 years or two first degree relatives diagnosed with an advance adenoma at any age. Benefit will be provided for colonoscopy from age 40 years, or 10 years before the age at diagnosis of the youngest affected relative, whichever is the first, and, if normal, repeats at five-yearly interval.
Adenomas - Low risk adenomas (tubular, 1-2, less than 1cm with low-grade dysplasia) identified on previous colonoscopy: Benefit will be provided for a repeat colonoscopy at 5 years (further endoscopy benefits may be paid if relevant pathology found at repeat colonoscopy)
Intermediate risk colonic adenomas (3-4 small adenomas, OR at least one adenoma 10-19mm identified on previous colonoscopy or any adenoma with villous features or high-grade dysplasia: Benefit will be provided for 3 yearly colonoscopies until 2 consecutive negative colonoscopies, then no further colonoscopies
High risk adenomas High risk adenomas (greater than or equal to 5 small or any adenoma ≥20mm). Annual colonoscopy until out of this risk group then interval colonoscopy as per intermediate risk group i.e. benefit will be provided for 3 yearly colonoscopy until 2 negative colonoscopies.
Colonoscopic surveillance for colorectal cancer from 8 years after onset of IBD.
Low-risk - Benefit will be provided for colonoscopy every 5 years.
Intermediate risk – i.e. extensive colitis with mild active disease or post-inflammatory polyps or history of colorectal cancer in a first degree relative aged 50 years or older - Benefit will be provided for colonoscopy every 3 years
High Risk, i.e. extensive colitis with moderate/severe active disease or stricture in past 5 years, or dysplasia in past 5 years, or concurrent primary sclerosing cholangitis, or colorectal cancer in a first degree relative under 50 years old - Benefit will be provided for colonoscopy every year
After colon surgery for FAP every 6 months if some rectal tissue remains and every year if all rectal tissue has been removed and there is a small intestinal pouch
Endoscopic Ultrasound |
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