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Clinical care standard to help weigh up colonoscopy risks, benefits

Colonoscopies should only be offered if the benefits outweigh the risks, according to a new nationally agreed standard of care for patients.

Launching the Colonoscopy Clinical Care Standard today in Brisbane, the Australian Commission on Safety and Quality in Healthcare argued that despite being frequently performed, colonoscopy is a complex medical procedure, so undergoing one unnecessarily “doesn’t make sense and may extend the wait time for those who do need it”.

Almost one million Australians have a colonoscopy each year and commission clinical director Anne Duggan says the new standard will offer guidance to patients, clinicians and health services.

“The clinical care standard supports clinician certification and recertification as requirements for colonoscopy services, and will bring increased rigour to the procedure and shine a light on when and how these procedures are done,” Duggan said.

Susan Morris has undergone annual colonoscopies since 2012, when she was diagnosed with Lynch syndrome, an inherited condition that puts her at increased risk of colon and endometrial cancers.

She said the standard will ensure those undertaking colonoscopies have a greater understanding of what to expect.

“In my experience, and speaking to many others like me who need to have regular colonoscopies, it is really important to know you are receiving high-quality care at all stages,” she said. “It is vital people understand what best practice means, and what standard of care they can expect. They also need to ensure they have followed the instructions for the bowel preparation. This makes abnormalities so much easier to detect.”

A colonoscopy examines the colon to diagnose and treat a range of bowel diseases including bowel cancer, the second most common cancer diagnosed in both men and women in Australia.

Over 4000 people in Australia are expected to die from bowel cancer in 2018.

Colorectal surgeon Iain Skinner co-chaired the commission’s working group that developed the standard and says the guidelines are much needed.

“This is an advanced procedure and we don’t want it being performed unnecessarily,” Skinner said. “Fewer unnecessary colonoscopies will free up access to more timely colonoscopies for those who are at moderate or high risk, such as those with a history of polyps or a significant family history of bowel cancer, or those who return a positive bowel screening test.”

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