GP Information

Information for GPs

Newcastle Colorectal Surgery is the largest and most experienced colorectal practice in Newcastle. We provide a comprehensive consultative, diagnostic and therapeutic colorectal service to the Hunter and New England districts with a dedicated on-call service for specialised colorectal emergencies, including endoscopic stent placement for colonic obstruction. We offer up-to-date, evidence based care and are all adept in minimally invasive (Key-hole) techniques.

We ensure all colorectal cancer referrals are seen within 1 week by one of our four surgeons.

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Rapid (Open) Access Colonoscopy

Our surgeons participate in the rapid access colonoscopy program both for public and private patients. It is a service for patients who have returned a positive faecal occult blood test (FOBT) and a rapid and streamlined method for General Practitioners to refer.

Rapid access colonoscopy, as the name suggests, reduces waiting times for patients requiring a colonoscopy. In most cases it removes then need for a consultation in the rooms/clinic prior to the procedure which also improves resource efficiency and saves patients money.

For rapid access referrals download the PDF below and fax to the appropriate location.

Important for Newcastle Endoscopy Centre referrals

Patients who are physically fit with clear indications for colonoscopy are suitable for open access. Patients who do not meet this criteria are those:

  • Frail, symptomatic or unwell
  • Over the age of 70 and under the age of 16
  • Have multiple chronic medical issues
  • Have poor mobility
  • BMI over 35

The Rapid Access Programme was initiated in 2013 within the Hunter New England Health Service and fully implemented in 2014. The initiative was a finalist in the NSW Health Awards Collaborative Team Category. A video link of this programme can be viewed here.

Finalist - 2015 NSW Health Awards

FOBT

Faecal Occult Blood Tests

This is a non-invasive, safe and less expensive way of screening the population for premalignant (Polyps) and malignant (Cancer) bowel tumours. FOBT's are immunochemical tests that utilise antibodies directed against human haemoglobin. They are less prone to false positive and can detect 80-90% of colorectal cancers.

The testing usually involves giving 3 separate specimens. A positive result is if any of the 3 separate specimens are positive. This usually indicates;

  • 50% chance of benign / no pathology
  • 45% chance of adenoma and
  • 5% chance of CRC

During a colonoscopy polyps are removed eliminating its chance of developing into a cancer. FOBT testing also discovers cancers at an earlier stage than symptomatic patients. Screening programmes using FOBT reduce mortality from colorectal cancer for these reasons.

The current NHMRC recommendations suggest that all patients between the ages 50-74 should undergo Screening FOBT every 2 years.

Symptomatic patients do not need a FOBT. They can be referred directly to see one of our surgeons.

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CT Colonography

Computerised tomographic colonography (CTc) or virtual colonoscopy utilises advanced CT imaging giving a non-invasive evaluation of the colon and rectum without the need for sedation. It also removes the 1/1000 risk of a significant colonoscopic complication and is therefore suitable for screening patients deemed unfit for a colonoscopy. CTc already has an established place in investigation following an incomplete colonoscopy. 

The downside is that if a polyp is found a colonoscopy is then usually required to remove it. Also, its ability for detecting asymptomatic colorectal lesions remains controversial. The senstivity for detecting polyps less than 1cm is 60% and those greater than 1cm is 83%.

The risk of a CTc is low however it should be noted that CT scans involve relatively large radiation doses. Given this, CTc remains indicated in specific situations only and not for routine surveillance application through the population, especially in the setting of repeated examinations.

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Clinical Practice Colorectal Cancer Guidelines

For further information on colorectal cancer in Australia download a copy of the GESA colorectal cancer updates below.

Colonoscopy Surveillance - Colorectal Cancer

Download a copy of the National guidelines for colonoscopy surveillance in patients following curative treatment for colorectal cancer.

Colonoscopy Surveillance - Adenomas

 Download a copy of the National guidelines for colonoscopy surveillance in patients following identification of adenomatous polyps.

Colonoscopy Screening - Family History

Download a copy of the colonoscopy screening guidelines for patients with a significant family history of colorectal cancer.

Colonoscopy Surveillance - IBD

Download a copy of the National recommendations for surveillance colonoscopy in patients with Inflammatory Bowel Disease.