Quick Reference Guide for Primary Health Teams - HP6836

Reviewed
March 2018

Gives information for primary health care providers about the National Bowel Screening Programme pathway, including communicating with patients when a test is positive, and colonoscopy.

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Details

Reviewed
March 2018
Format
Online only
HE code
HP6836
Language
English

The full resource:

The National Bowel Screening Programme offers screening to the eligible population aged 60–74 years, every two years.

Primary care has an important part to play in the success of the National Bowel Screening Programme.

General Practitioners and practice nurses will discuss and manage positive test results with their patients. They also have a key role in encouraging participation, helping achieve equity, and raising awareness of bowel cancer symptoms and family history.

POSITIVE TEST RESULTS
  • GPs receive results electronically from the bowel screening testing laboratory
  • GPs/Practice Nurses advise their patients of positive results and refer them for colonoscopy
PROCESS FOR MANAGING POSITIVE RESULTS
  • Contact the patient
  • Advise the patient of the positive result
  • Discuss the implications of the positive result (see below)
  • Refer the patient for colonoscopy
COLONOSCOPY REFERRALS
  • Patients to be referred for a national bowel screening colonoscopy within 10 working days
  • Referrals to be forwarded to the hospital in the DHB where the patient is domiciled using the standard referral process
COLONOSCOPY
  • A colonoscopy appointment must be offered within 45 working days of the GP’s receipt of the result
CLAIMS AND PAYMENT
  • The fee for the management of a positive result is $60 + GST
  • Funding for the NBSP referral consultation will be claimed using standard local systems
  • The fee can be claimed for patients who decline referral or who are referred privately provided the DHB colonoscopy unit is notified
NEGATIVE TEST RESULTS
  • Negative results are advised to patients by letter sent from the National Bowel Screening Coordination Centre
  • No GP action is required for negative results

 

Support and further information

National Bowel Screening Pathway

1 Assessment of family history, in accordance with Guidance on Surveillance: www.health.govt.nz/publication/guidance-surveillance-people-increased-risk-colorectal-cancer

Positive results information for patients

What does a positive test result mean?

A positive test result does not necessarily mean you have bowel cancer.

Small amounts of blood in your bowel motion are most commonly caused by polyps, or other minor conditions such as haemorrhoids (piles), which can easily be treated.

If your test is positive it means you will need a further investigation. This will usually be a colonoscopy (an internal examination of the large bowel).

Your doctor or a nurse will contact you to discuss your results and the type of follow up test that is right for you.

If you have a family history of bowel cancer, you may also be advised to see your doctor, or be referred to the New Zealand Familial Gastrointestinal Cancer Service.

What does a colonoscopy involve?

A colonoscopy involves a specially trained health professional putting a thin tube into your anus (bottom). There is a very small camera on the end of the tube which is used to examine the lining of your bowel, to see if there are any problems.

A colonoscopy can identify whether polyps or cancers are present.

If a cancer is found a small sample or biopsy will be taken and if polyps (growths) are found they will generally be removed. The samples or removed polyps are sent to the laboratory for analysis to check for cancer.

Polyps are not cancers, but may turn into a cancer over a number of years. Taking a biopsy or removing polyps is usually painless.

About seven in 10 people who have a colonoscopy as part of the National Bowel Screening Programme will have polyps, which if removed may prevent cancer developing

About seven in 100 people who have a colonoscopy as part of the National Bowel Screening Programme will be found to have cancer and most will require treatment

Are there risks from a colonoscopy?

Colonoscopy is considered a safe procedure. However, as with most medical procedures, problems can sometimes happen.

There is a small risk the colonoscopy procedure itself, or removal of polyps, will cause bleeding or damage to your bowel and you may need further treatment.

Code: HP6836

Further information