Change of surveillance guidance for people who had had polyps removed

Today the British Society of Gastroenterology have updated their guidelines to consider the use of surveillance, or ‘check-up’ colonoscopies for people who have had polyps (pre-cancerous growths) or bowel cancer removed, published in GUT journal.

A colonoscopy is one of the main tests that can diagnose bowel cancer. It’s a camera on a thin, flexible cable inserted through the anus to look at different parts of the bowel. The test can also remove polyps, which can lower the risk of bowel cancer. The earlier bowel cancer is detected, the more successful the treatment is and the greater chance of surviving.

If a patient has had polyps removed, the new BSG guidelines state:

• For people eligible for national bowel cancer screening, or within 10 years of the lower age limit (aged 50 – 74, or aged 40 – 74 in Scotland): If they have a low risk of a bowel cancer diagnosis in the future, they won’t be invited to have another colonoscopy in two years’ time. Instead they will be asked to complete a national bowel cancer screening test every two years.
• For people who are aged more than ten years younger than the national bowel screening lower age limit (aged 49 and under, or aged 39 and under in Scotland): If they have a low risk of a bowel cancer diagnosis in the future, they will be considered for a colonoscopy in five or ten years. If they’re considered to have a high risk of bowel cancer, they will receive a check up every three years.
• For people aged 75 and over: They won’t be offered a colonoscopy as the benefits of having the test outweigh the risks, such as a stroke, heart or kidney problems.

For people who have had bowel cancer removed, they should receive another colonoscopy one year after their diagnosis followed by a further surveillance colonoscopy after three years.

These updated guidelines aim to make ‘check ups’ more personalised, ensuring a colonoscopy is recommended for people who need it. This will also reduce unnecessary investigations for those who won’t benefit from them. This is the first time the guidelines have been updated since the national bowel cancer screening programme was introduced (in England in 2006, Scotland in 2007, Wales in 2008 and in Northern Ireland in 2010).

Dr Lisa Wilde, Director of Research and External Affairs at Bowel Cancer UK, says: “Finding better, more personalised ways to prevent bowel cancer developing in the first place is crucial and removing polyps before they turn into bowel cancer is key to this. That’s why we welcome these updated guidelines, which take the latest evidence into account.”

“These guidelines are being applied retrospectively, therefore for some people this means that their already planned ‘check up’ colonoscopies will change.”

If you’ve been affected by these updated guidelines, please speak to your GP or medical team.

• Read our blog explaining the changes to the BSG guidelines for people who have a low risk of bowel cancer
• Learn more about tests that can diagnose bowel cancer
• Find out more about how we plan to tackle long waiting times in our End the Capacity Crisis campaign