Download Corresponding Letter - Midland Cancer Network

No.1 The Terrace
PO Box 5013
Wellington 6145
New Zealand
T+64 4 496 2000
1 October 2015
Revised Direct Access for Colonoscopy Criteria
Direct Access for Colonoscopy criteria was developed by the National Bowel Cancer
Working Group (NBCWG) in 2012 to guide referrals for colonoscopy. The Ministry
worked with DHBs to implement the criteria and expect that they are consistently used
to triage referrals for colonoscopy across New Zealand.
In 2014 the Ministry hosted an Endoscopy Workforce Symposium. The role of CT
Colonography was highlighted, and it was agreed that the criteria would be amended to
more clearly incorporate CT Colonography as a procedure for bowel investigation.
The enclosed criteria include minor revisions around the use of CT Colonography. The
revisions were achieved through discussion at the NBCWG and with representatives of
professional groups. Specifically, the criteria now states:
“District health board (DHB) services are now encouraged to provide direct access to
colonoscopy and CT Colonography for appropriate patients. There should be a single
point of entry and triage of referrals for bowel investigation by either colonoscopy or CT
Colonography.”
“In referring a patient for a bowel investigation the referrer should:
 be aware that colonoscopy is the appropriate investigation where
a) *diarrhoea or rectal bleeding (non-outlet type) is the predominant indication
b) *a patient has a Category 2 or 3 family history of bowel cancer
 be aware that CT Colonography is an appropriate investigation where the above*
are not the predominant indication or the patient being referred is over 80 years
and/or has significant co-morbidities”
The NBCWG has endorsed the above revisions.
We have also taken this opportunity to update the criteria to reflect the Faster Cancer
Treatment Indicators (FCT). The following points are now included in Comments for
Services.


Patients who meet the ‘two week category’ at referral are considered to have
high suspicion of cancer and are included in the 62 day Faster Cancer Treatment
health target.
All patients with a confirmed cancer diagnosis, including incidental diagnosis or
as a result of a ‘six week category’ investigation, are included in the 31 day
Faster Cancer Treatment indicator.
Please note that a full review of the criteria is planned for 2017.
If you have any major concerns please let us know in writing by email to
[email protected] by 14 October.
Yours sincerely
Ian Bissett
General and Colorectal Surgeon
Chair
National Bowel Cancer Working Group
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Susan Parry
Gastroenterologist
Clinical Director, Bowel Cancer
Sector Capability and Implementation