Report in English with a Dutch summary (KCE reports 45A)

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176 Screening for Colorectal Cancer: Appendices KCE reports vol.45 Nr. Title Issued by Year Familial Adenomatous Polyposis (FAP) & related 2 ASGE guideline: colorectal cancer screening and surveillance 184. Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy (ASGE) 2006 1. FAP with positive genetic test result in proband: offer genetic testing with counseling. In relatives with positive genetic testing, annual FS beginning at age 10-12 y with colectomy when polyps develop. If no polyps are detected, annual FS until age 40 y, then every 3-5 y. Relatives with negative genetic test results are assumed not to be affected; however, they can be offered FS every 7-10 y until age 40 y then colonoscopy every 5 y. 2. FAP with negative genetic test result in proband: annual FS in all potentially affected relatives beginning at age 10-12 y as outlined above. Recommendation grade B Hereditary Non-Polyposis Colon Cancer (HNPCC) Colonoscopy every 1-2 y beginning at age 20-25 y, or 10 y younger than the earliest age of diagnosis of CRC in the family, whichever is earlier. Annual colonoscopy should be performed after age 40 y. Recommendation grade B Personal history of CRC resection 1. Prior colon cancer: high quality clearance of remainder of the colon at or around time of resection, followed by colonoscopy at 1 y after curative resection, then at 3 y and then 5-y intervals if results are normal 2. Prior rectal cancer: colonoscopy: clearance of remainder of colon at or around time of resection, followed by colonoscopy at 1 y and 4 y after resection, then at 5-y intervals. 3. After low anterior resection, if no pelvic radiation or no mesorectal excision: FS every 3-6 m for 2-3 y. Recommendation grade B Personal history of colonpolyps 1. Prior colonic adenomas 2 small tubular adenomas (< 1 cm) and only lowgrade dysplasia surveillance colonoscopy every 5 y 2. 3-10 adenomas surveillance colonoscopy every 3 y 3. > 10 adenomas surveillance colonosocpy within 3 y 4. Large sessile polyp with potentially incomplete excision: repeat colonoscopy within 2-6 m. Negative surveillance colonoscopy repeat every 5 y. Recommendation grade B Inflammatory bowel disease (IBD) Patients with UC or extensive Crohn s colitis, greater than one third colonic involvement, should undergo surveillance colonoscopy every 1-2 y beginning 8 to 10 years after disease onset. Biopsy specimens of the colon in patients with documented pancolitis should be obtained in all 4 quadrants every 10 cm from the cecum to the rectum, to obtain a minimum of 32 biopsy samples. In patients with less extensive colitis, biopsy specimens can be limited to the microscopically involved segments. The presence of high-grade dysplasia or multifocal low-grade dysplasia in flat mucosa is an indication for colectomy. Recommendation grade B Miscellaneous Not included
KCE reports vol.45 Screening for Colorectal Cancer: Appendices 177 3 Guidelines for colonoscopy surveillance after polypectomy61, 62. US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society 2006 Not included Not included Not included 1. Patients with small rectal hyperplastic polyps should be considered to have normal colonoscopies, and therefore the interval before the subsequent colonoscopy should be 10 years. An exception is patients with a hyperplastic polyposis syndrome. They are at increased risk for adenomas and colorectal cancer and need to be identified for more intensive follow up. 2. Patients with only one or two small (< 1 cm) tubular adenomas with only low-grade dysplasia should have their next follow-up colonoscopy in 5 to 10 years. The precise timing within this interval should be based on other clinical factors (such as prior colonoscopy findings, family history, and the preferences of the patient and judgment of the physician). 3. Patients with 3 to 10 adenomas, or any adenoma > 1 cm, or any adenoma with villous features, or high-grade dysplasia should have their next follow-up colonoscopy in 3 years providing that piecemeal removal has not been done and the adenoma(s) are completely removed. If the follow-up colonoscopy is normal or shows only one or two small tubular adenomas with lowgrade dysplasia, then the interval for the Not included Not included
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KCE reports vol.45A Colorectale Kan
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KCE reports 1. Effectiviteit en kos
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Report in English with a Dutch summary (KCE reports 45A)

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