TBA (16S144)

Audit of Screening Colonoscopy Referrals for Invididuals with a Family History of Colorectal Carcinoma


Desmond Thong Seamus O'Mahony


Gastroenterology Department, Cork University Hospital


Demand for endoscopy (particularly colonoscopy) continues to rise. GPs commonly refer asymptomatic patients with a family history of colorectal carcinoma (CRC) for screening colonoscopy. It has been our anecdotal impression that many of these referrals are inappropriate. preprocess


The aim of this audit is to determine if our impression that many of these screening colonoscopy referrals do not meet current guidelines. preprocess


All referrals from GPs for screening colonoscopy (based on family history) to the Gastroenterology Department at Cork University Hospital during 2014 and 2015 were gathered. Only asymptomatic patients were included in this audit. Referrals were assessed for appropriateness against the current guidelines set by the British Society of Gastroenterology, which advises screening colonoscopy in asymptomatic individuals with one first-degree relative with CRC under the age of 50, or two first-degree relatives with CRC of any age. preprocess


Out of the 22 patients included in this audit, only 2 fulfilled the criteria for CRC screening. The commonest reason for failure to fulfill CRC screening criteria was age of first degree relatives with CRC. Of the 20 patients who did not meet the criteria of CRC screening, 3 patients had first degree relatives who did not have CRC at all, but other forms of malignancy. preprocess


The vast majority of referrals for screening colonoscopy were inappropriate. A previous audit from our unit also documented a high rate (50%) of inappropriate request for colonoscopy to investigate anaemia. There is a need to increase awareness among GPs regarding indications for screening colonoscopy. preprocess