Bowel Screening & Diagnostics across Brisbane & the Gold Coast

Bowel screening overview

Bowel Screening is very effective in the early detection bowel cancer and pre-cancerous polyps. It is also a useful tool to diagnose gastrointestinal/bowel problems. In patients with a risk for colorectal cancer, the Australian government through the National Health and Medical Research Council (NHMRC) recommends the faecal occult blood testing (FOBT) at the age of 50. This will help identify patients in whom a formal colonoscopy is required. However, as with all screening tests, there is a significant miss-rate that exposes patients to risk. The FOBT test is not suitable for patients with abdominal symptoms.

Dr Terence Chua recommends patients with abdominal symptoms to have a clinical review. This will allow the symptoms to be ascertained by close history taking and clinical examination. From this process, the most appropriate diagnostic tool can be used to reach a diagnosis.

Why should I undertake bowel screening?

Bowel screening presents a real opportunity to prevent bowel cancer in everyone. This is achieved through the early detection of polyps and removal of polyps. This prevents the development of cancer for which the polyp is a pre-cancerous lesion.

What are the different types of bowel screening?

In the asymptomatic patient, who has a family history of colorectal cancer, it is recommended that a colonoscopy be performed. Based on the findings of the colonoscopy, a surveillance protocol can then be instituted to address the specific risk profile of the patient.

In the symptomatic patient, a different screening or investigation process will need to take place. This often requires a battery of imaging tests such as a computed tomography (CT) scan to have gross structural imaging of the gastrointestinal tract to identify pathology, followed by colonoscopy.

Gastroscopy is a diagnostic tool used to visualise the upper gastrointestinal tract from the mouth to the duodenum (first portion of the small intestine). In patients not suitable for a colonoscopy (due to technical reasons or anatomical reasons), a CT colonography may be considered. The CT colonography has an equivalent pick-up rate to colonoscopy for larger polyps however, may not be sufficiently sensitive to detect smaller polyps. In addition, should polyps be identified on CT colonography, removal of polyps will need to be performed by colonoscopy or surgery. Hybrid techniques of colonoscopy with laparoscopy may be considered in selected patients to simultaneously view and manipulate the inside and outside surfaces of the bowel wall, making it easier to locate and treat many polyps. As gastroenterologist removing large polyps via standard colonoscopy must consider the risk of bowel injury and perforation, the hybrid technique affords the laparoscopic surgeon the ability to apply suturing or stapling techniques to address any injury.