Table 2

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

High risk disease groups		Screening procedure	Time of initial screen	Screening procedure and interval	Procedures/yr/300,000
Colorectal cancer		Consultation, CT, LFT's & Colonoscopy	Colonoscopy within 6 months of resection only if colon evaluation pre-op. incomplete	CT Liver Scan within 2 years post-op. Colonoscopy 5 yearly until co-morbidity outweighs	175

Colonic adenomas	Low risk 1-2 adenomas, both <1 cm	Colonoscopy	5 years or no surveillance	Cease follow-up after negative colonoscopy
	Intermediate risk 3–4 adenomas, OR at least one adenoma ≥1 cm	Colonoscopy	3 years	3 yearly until 2 consecutive negative colonoscopies, then no further surveillance
	High risk ≥5 adenomas or ≥3 with at least one ≥ 1cm	Colonoscopy	1 year	Annual colonoscopy until out of this risk group then interval colonoscopy as per intermediate risk group
	Piecemeal polypectomy	Colonoscopy or flexi-sig (depending on polyp location)	3 months—consider open surgical resection if incomplete healing of polypectomy scar

Ulcerative colitis and Crohn's colitis	Low risk Extensive colitis with no inflammation or left sided colitis or Crohn's colitis of <50% colon	Pancolonic dye spray with targeted biopsy. If no dye spray then 2–4 random biopsies every 10 cms.	10 years from onset of symptoms	5 years	20
	Intermediate risk Extensive colitis with mild active disease or post-inflammatory polyps or family history of colorectal cancer in a FDR <50 yrs.			3 years	10
	High risk Extensive at least moderate colitis or stricture in past 5 years or dysplasia in past 5 years (declining surgery) or PSC or OLT for PSC) or colorectal cancer in a FDR <50 yrs.			1 year	6
Uretero-sigmoidostomy		Flexi Sig	10 yrs after surgery	Flexi Sig annually	3
Acromegaly		Colonoscopy	At 40 yrs.	Colonoscopy 5 yearly	1

CT, Computed tomography; LFT's, liver function tests; OLT, orthoptic liver transplant; PSC, primary sclerosing cholangitis.