NEW ONLINE TOOLS

Online CRC Screening & Surveillance Decision-Support Tools

GPs play a crucial role in colorectal cancer prevention, but CRC screening and surveillance guidelines are often complex, detailed, and difficult to recall during a busy consultation. Family history recommendations are often misunderstood, while post-polypectomy surveillance intervals require consideration of multiple factors and findings across previous colonoscopies.

These challenges can contribute to both over-surveillance and under-surveillance, potentially impacting patient outcomes and resource utilisation.

Dr Joshua Butt has developed two practical online decision-support tools to help GPs navigate the often-complex recommendations surrounding colorectal cancer (CRC) screening and post-polypectomy surveillance.

1.FAMILY HISTORY CRC SCREENING TOOL

Assists clinicians in determining the appropriate CRC screening pathway based on a patient’s family history. This tool:

Applies current Australian family history recommendations
Helps classify patients into CRC risk categories
Provides screening recommendations based on family history and age
Simplifies guideline application during routine consultations
Supports, but does not replace, clinical judgement

Reminder – When assessing CRC risk:

Both maternal and paternal family histories are important
The age at diagnosis of affected first-degree relatives matters
Family history information may be incomplete or inaccurate
Symptomatic patients require diagnostic investigation rather than screening
Patients in the highest-risk groups may require referral to a Familial Cancer Clinic or Genetics Service

2.POLYP SURVEILLANCE TOOL

Helps determine recommended surveillance intervals following polyp detection and removal.

This tool is particularly valuable because surveillance recommendations depend on cumulative findings from previous colonoscopies and can be difficult to calculate manually.

The tool incorporates key variables including-

Number of adenomas
Adenoma size and advanced features
Number of serrated lesions
Presence of dysplasia or other advanced serrated pathology
Findings from multiple colonoscopy examinations

Important limitations: The tool relies on accurate histology results, bowel preparation assessment, documentation of complete excision and family history information.

It is not intended for patients with hereditary cancer syndromes or inflammatory bowel disease (IBD).