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Colonoscopic surveillance overview

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Colonoscopic surveillance

About

What is covered

This pathway covers colonoscopic surveillance to prevent colorectal cancer in adults with ulcerative colitis, Crohn's disease or adenomas.
Some people with inflammatory bowel disease (ulcerative colitis or Crohn's disease) or with adenomas have a higher risk of developing colorectal cancer than the general population.
In this pathway 'adenomas' is used to refer to precancerous polyps. Adenomas larger than 10 mm are more likely to progress to invasive cancers.
Colonoscopic surveillance can identify precancerous lesions early and prevent progression to colorectal cancer. It can also identify invasive cancer at an early stage. The aim of this guideline is to reduce the variation in the timing, frequency and method of surveillance to improve the care of people with inflammatory bowel disease or adenomas at increased risk of developing colorectal cancer.

Updates

Updates to this pathway

23 August 2016 Pathway restructured and summarised recommendations replaced with full recommendations.

Professional responsibilities

The recommendations in this pathway represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take these recommendations fully into account, alongside the individual needs, preferences and values of their patients or service users. Applying the recommendations in this pathway is at the discretion of health and care professionals and their individual patients or service users and does not override the responsibility of health and care professionals to make decisions appropriate to the circumstances of the individual, in consultation with them and/or their carer or guardian.
Commissioners and/or providers have a responsibility to enable the recommendations to be applied (and to provide funding required for technology appraisal guidance) when individual health and care professionals and their patients or service users wish to use them. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this pathway should be interpreted in a way that would be inconsistent with compliance with those duties.

Patient-centred care

People have the right to be involved in discussions and make informed decisions about their care, as described in your care.
Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.

Short Text

Everything NICE has said on colonoscopic surveillance for people with inflammatory bowel disease or adenomas in an interactive flowchart.

What is covered

This pathway covers colonoscopic surveillance to prevent colorectal cancer in adults with ulcerative colitis, Crohn's disease or adenomas.
Some people with inflammatory bowel disease (ulcerative colitis or Crohn's disease) or with adenomas have a higher risk of developing colorectal cancer than the general population.
In this pathway 'adenomas' is used to refer to precancerous polyps. Adenomas larger than 10 mm are more likely to progress to invasive cancers.
Colonoscopic surveillance can identify precancerous lesions early and prevent progression to colorectal cancer. It can also identify invasive cancer at an early stage. The aim of this guideline is to reduce the variation in the timing, frequency and method of surveillance to improve the care of people with inflammatory bowel disease or adenomas at increased risk of developing colorectal cancer.

Updates

Updates to this pathway

23 August 2016 Pathway restructured and summarised recommendations replaced with full recommendations.

Sources

The NICE guidance that was used to create the pathway.
Computed tomographic colonography (virtual colonoscopy) (2005) NICE interventional procedures guidance 129

Quality standards

Quality statements

Effective interventions library

Effective interventions library

Successful effective interventions library details

Implementation

These resources include support for commissioners to plan for costs and savings of guidance implementation and meeting quality standards where they apply.
These resources will help to inform discussions with providers about the development of services and may include measurement and action planning tools.
NICE produces resources for individual practitioners, teams and those with a role in education to help improve and assess users' knowledge of relevant NICE guidance and its application in practice.
These resources provide help with planning ahead for NICE guidance, understanding where you are now, and conducting improvement initiatives.

Information for the public

NICE produces information for the public that summarises, in plain English, the recommendations that NICE makes to healthcare and other professionals.
NICE has written information for the public explaining its guidance on each of the following topics.

Pathway information

Professional responsibilities

The recommendations in this pathway represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take these recommendations fully into account, alongside the individual needs, preferences and values of their patients or service users. Applying the recommendations in this pathway is at the discretion of health and care professionals and their individual patients or service users and does not override the responsibility of health and care professionals to make decisions appropriate to the circumstances of the individual, in consultation with them and/or their carer or guardian.
Commissioners and/or providers have a responsibility to enable the recommendations to be applied (and to provide funding required for technology appraisal guidance) when individual health and care professionals and their patients or service users wish to use them. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this pathway should be interpreted in a way that would be inconsistent with compliance with those duties.

Patient-centred care

People have the right to be involved in discussions and make informed decisions about their care, as described in your care.
Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.

Supporting information

Risk of developing colorectal cancer in people with adenomas
Low risk
  • one or two adenomas smaller than 10 mm.
Intermediate risk
  • three or four adenomas smaller than 10 mm or
  • one or two adenomas if one is 10 mm or larger.
High risk
  • five or more adenomas smaller than 10 mm or
  • three or more adenomas if one is 10 mm or larger.

Glossary

ulcerative colitis or Crohn's disease
precancerous polyps
precancerous polyp

Paths in this pathway

Pathway created: November 2011 Last updated: August 2016

© NICE 2016

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