Family History of Colorectal Cancer (CRC)

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
  • Family history of cancer including:
    • Details of the family members relationship to patient and family members age at diagnosis of colorectal cancer (CRC) or polyps.
    • Any family history of uterine, ovarian, gastric or small intestinal tumour.
  • If previous colonoscopy, please detail last colonoscopy report and histology. If possible or date and site of examination.
  • Medication especially anticoagulants and reason for prescription, iron, NSAIDs, steroids and hypoglycaemic agents.
  • History of cardiovascular disease, renal disease, liver disease, diabetes

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:

Note: Referrals of asymptomatic patients deemed not to meet guidelines will be returned to the referrer.

DO NOT REFER

  • Asymptomatic individuals with no family history of colorectal cancer
    (Yearly FOBT recommended in average risk patients over 50 years of age)
  • Asymptomatic individuals with a single family member affected at > 55 years of age (as per NHMRC guidelines). Yearly FOBT as above

For more information please see the Tasmanian Health Pathways website.

Routine / category 3

Possible  Hereditary Non-Polyposis Colon Cancer Syndrome (or Familial Polyposis)

Multiple relatives with colorectal cancer, other GI cancer or uterine cancer and at least one relative with age of onset of cancer <50 years of age

  • Refer at 25 years of age for consideration of screening

Other family history of colorectal cancer

  • Refer at 50 years of age or 10 years of age earlier than the age at which the youngest first degree relative was diagnosed with CRC, whichever comes first
  • Two first degree relatives or second degree relatives on same side of family

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 (2011)

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6348 7382
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6426 5115
NWRH ED – Phone: (03) 6493 6340  Fax: (03) 6430 6691
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6222 8919

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