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Family History of Colorectal Cancer

Checked: 23-03-2019 by Vicky Ryan Next Review: 23-03-2020

Overview

The Colorectal Cancer (CRC) family history guidelines (PDF) have been designed to direct appropriate referrals for CRC family history to Clinical Genetics and/or Endoscopy/Gastroenterology and are based on published guidelines.

The guidelines were written in 2010 by the local Genetics Department. They are due for review but we have been advised by the Dr Alan Donaldson (genetics consultant at St Michaels Hospital) that they can still be used to guide appropriate managment and referral in most patients.

Please note that the Amsterdam criteria used to identify Lynch syndrome/HNPCC only are met if all the listed criteria apply.

This can be a difficult area to understand, and if clarification is needed about the appropriate referral route for a patient, then please contact the on-call genetic Counsellor on: 0117 342 5107.

These guidelines only apply to asymptomatic individuals. If a patient has symptoms they should be investigated and referred according to existing pathways.

Referrals

Referral to Genetics

Referral to Clinical Genetics Clinic at St Michaels is via the Clinical Genetics RAS (Referral Assessment Service) on eRS. Please include a detailed family history.

Once a referral has been received then it will be reviewed by the genetics team and it will be dealt with in one of the following ways:

If the family history is already known or a family member has been seen in the genetics clinic previously then an appointment may be offered in the clinic.
If further information is required, the patient may be contacted by a Genetic Counsellor, in order to obtain a family history (if not supplied) and to discuss the condition and answer any questions the patient has regarding the referral.
If, after assessment, a clinic appointment is not necessary the team will provide advice by letter to the referring doctor or health care professional.

Referral for colonoscopy

If required a referral for colonscopic surveillance can be made to endoscopy services via eRS.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.