Managing Surveillance for Colorectal Cancer: The Importance of Microcomputers

Large scale screening programmes for colorectal cancer based on genetic risk are difficult to administer because of the need to identify at-risk family members and ensure that surveillance proceeds in an orderly fashion over a lifetime. As at August 1989, 1100 high risk persons have been registered with the Royal Melbourne Hospital Surveillance Programme. Categorisation of risk is done after evaluation of the family’s history of cancer. Surveillance protocols are then defined based on the intensity of cancer in the family. Annual occult blood testing is performed in all groups. Colonoscopy is performed every 2 years on at-risk members of families with hereditary non-polyposis colon cancer syndromes (n = 35 families) and 3 to 5 yearly for individuals with two or more first-degree relatives with sporadic colorectal cancer. Flexible sigmoidoscopy is performed every 3 years on some individuals with one affected first-degree relative, particularly where there are other affected relatives more remotely placed in the family. Patients who have had an adenoma/cancer undergo 3-yearly colonoscopy.