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Colonoscopy for high-risk surveillance patients during COVID-19
14 April 2021

Updated on 7 April 2021

For the latest guidance on COVID-19, please see this page on the JAG website which is regularly updated.


The Covid-19 pandemic has resulted in unavoidable delays to surveillance colonoscopy. However, these surveillance procedures remain important, as there is an inevitable risk that these delays may result in delayed cancer diagnoses. This may be a particular concern for those people whose risk of colorectal cancer is highest, for example those patients with high risk genetic conditions such as Lynch syndrome, post-polypectomy ‘site checks’, many IBD surveillance patients, and early post-cancer surveillance populations.

As an update to the below guidance published in January 2021, we would recommend the following:

1. For patients due surveillance colonoscopy at an interval of less than 3 years, we recommend that this is performed within 6 months of the original due date.

2. For patients due surveillance colonoscopy at an interval of 3 or more years, we recommend that a colorectal surveillance procedure be performed within 12 months of their original due date (i.e. this may include surveillance modalities other than colonoscopy, where deemed clinically appropriate).
Stool FIT testing can be considered for patients on surveillance waiting lists who are overdue, to prioritise those for expedited or urgent colonoscopy, in line with existing guidance.

We recognise the pressures many endoscopy services are under at present, but it is imperative that senior clinicians continue to triage patients according to clinical need and target the resources available to those at highest clinical risk of serious disease and where further delay risks adverse outcomes.

Ian Penman, BSG 

Kevin Monahan, Colorectal Committee

Ian Arnott, IBD committee

Mark Coleman, JAG

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