Excerpt

Colonoscopic surveillance in people at high risk of developing colorectal cancer can detect precancerous changes early on and potentially prevent progression to colorectal cancer. It can also identify invasive cancer early. However, in clinical practice there is variation in when colonoscopic surveillance starts and how frequently it is offered to people at high risk. This NICE short clinical guideline aims to improve the care of people with inflammatory bowel disease (IBD) or adenomas at high risk of developing colorectal cancer by making evidence-based recommendations on the use of colonoscopic surveillance.

Contents

• Disclaimer
• Introduction
• Patient-centred care
• 1. Summary
  • 1.1. List of all recommendations
  • 1.2. Care pathways
  • 1.3. Overview
• 2. How this guideline was developed
  • 2.1. Introduction
  • 2.2. Clinical effectiveness of colonoscopic surveillance compared with no surveillance
  • 2.3. Colonoscopic surveillance techniques
  • 2.4. Conventional colonoscopy compared with chromoscopy
  • 2.5. Initiation and frequency of surveillance
  • 2.6. Providing information and support
• 3. Research recommendations
  • 3.1. Surveillance programmes for people at increased risk of colorectal cancer
  • 3.2. Natural history of progression to colorectal cancer in people at increased risk
  • 3.3. Effectiveness of biomarkers for determining level of risk of colorectal cancer
  • 3.4. Adenoma types and risk of colorectal cancer
• 4. Other versions of this guideline
  • Quick reference guide
  • ‘Understanding NICE guidance’
• 5. Related NICE guidance
  • Published
  • Under development
• 6. Updating the guideline
• 7. References, glossary and abbreviations
  • 7.1 References
  • 7.2 Glossary
  • 7.3 Abbreviations
• 8. Contributors
  • 8.1. The Guideline Development Group
  • 8.2. The short clinical guidelines technical team
  • 8.3. The Guideline Review Panel
  • 8.4. Declarations of interest
  • 8.5. Authorship and citation
• Appendix1. Scope
• Appendix 2. Review questions and review protocol
• Appendix 3. Results of GDG short questionnaires
• Appendix 4. Lists of excluded studies
• Appendix 5. Search strategies and literature search
• Appendix 6. Evidence tables
• Appendix 7. Cost-effectiveness analysis for inflammatory bowel disease
• Appendix 8. Cost-effectiveness analysis of colonoscopic surveillance: adenomas

NICE clinical guidelines are recommendations about the treatment and care of people with specific diseases and conditions in the NHS in England and Wales.

This guidance represents the view of NICE, which was arrived at after careful consideration of the evidence available. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. However, the 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, and informed by the summary of product characteristics of any drugs they are considering.

Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.