New three month colonoscopy waits worry experts

Australian Doctor

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Proposed changes to NHMRC colorectal cancer guidelines that allow three month waits for colonoscopies have been met with strong criticism from Bowel Cancer Australia.
The nearly 500 page draft guidelines, two years in the making, were posted to the Cancer Council Australia website last Thursday.
Bowel Cancer Australia’s director, Associate Professor Graham Newstead, a colorectal surgeon, said he was particularly worried about the change in the recommended time to colonoscopy for patients with symptoms suggestive of bowel cancer or after positive FOBT.
The draft guidelines push colonoscopy timelines for these patients to 120 days, up from the present 30 days.
“They base this new recommendation largely on consensus, with only grade C and D evidence, which may not be enough,” said Dr Newstead, who heads up the colorectal unit at Sydney’s Prince of Wales Private Hospital.
Two recent papers — one in Cancer Epidemiology, Biomarkers and Prevention and the other in Clinical Gastroenterology and Hepatology — went against this new recommendation, supporting colonoscopy within 30 days for patients with a positive FOBT to minimise their risk of mortality, he said.
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