2.3 Initial referral

2.3 Initial referral

All patients referred for colonoscopy should be seen by a specialist accredited in colonoscopy by the Conjoint Committee of the Royal Australasian College of Surgeons, Royal Australasian College of Physicians and Gastroenterological Society of Australia) to make the diagnosis.

Patients should be enabled to make informed decisions about their choice of specialist and health service. General practitioners should make referrals in consultation with the patient after considering the clinical care needed, cost implications (see referral options and informed financial consent), waiting periods, location and facilities, including discussing the patient’s preference for health care through the public or the private system.

Referral for suspected or diagnosed colorectal cancer should include the following essential information to accurately triage and categorise the level of clinical urgency:

  • important psychosocial history and relevant medical history
  • family history, current symptoms, medications and allergies
  • results of current clinical investigations (imaging and pathology reports)
  • results of all prior relevant investigations
  • notification if an interpreter service is required.

Many services will reject incomplete referrals, so it is important that referrals comply with all relevant health service criteria.

If access is via online referral, a lack of a hard copy should not delay referral.

The specialist should provide timely communication to the general practitioner about the consultation and should notify the general practitioner if the patient does not attend appointments.

If a pathological (or endoscopic) diagnosis has been made, the patient should be referred to a general or colorectal surgeon affiliated with (or with access to) a multidisciplinary team. Some early cancers can be managed by endoscopy alone without surgical consultation but should also be considered by a multidisciplinary team.

Aboriginal and Torres Strait Islander patients will need a culturally appropriate referral. To view the optimal care pathway for Aboriginal and Torres Strait Islander people and the corresponding quick reference guide, visit the Cancer Australia website. Download the consumer resources Checking for cancer and Cancer from the Cancer Australia website.

If symptoms suggest colorectal cancer, patients should be referred and a colonoscopy completed within four weeks of the general practitioner referral.

Patients should be seen by the surgeon within two weeks of the general practitioner referral following a positive diagnosis of colorectal cancer via colonoscopy. Patients should bring a copy of the colonoscopy report and other relevant medical and psychosocial history.