Barrett's oesophagus surveillance
Emergency referrals
All urgent cases must be discussed with the on call Gastroenterology Registrar to obtain appropriate prioritisation and treatment. Contact through
- Royal Brisbane and Women's Hospital (07) 3646 8111
- The Prince Charles Hospital (07) 3139 4000
- Redcliffe Hospital (07) 3883 7777
- Caboolture Hospital (07) 5433 8888
Urgent cases accepted via phone must be accompanied with a written referral and a copy faxed immediately to the Central Patient Intake Unit: 1300 364 952.
Does your patient wish to be referred?
Minimum referral criteria
Does your patient meet the minimum referral criteria?
Category 1
Appointment within 30 days is desirable
- No category 1 criteria (see other useful information for referring practitioners)
Category 2
Appointment within 90 days is desirable
- No category 2 criteria (see other useful information for referring practitioners
Category 3
Appointment within 365 days is desirable
- No category 3 criteria (see other useful information for referring practitioners)
If your patient does not meet the minimum referral criteria
Consider other treatment pathways or an alternative diagnosis.
If you still need to refer your patient:
- Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
- Please note that your referral may not be accepted or may be redirected to another service
Other important information for referring practitioners
Not an exhaustive list
Australian clinical practice guidelines for the diagnosis and management of Barrett’s oesophagus and early oesophageal adenocarcinoma (2015) recommended screening endoscopy schedules.
No dysplasia on endoscopic assessment and Seattle protocol biopsy
- Short (< 3 cm) segment – repeat endoscopy in 3–5 years
- Long (≥ 3 cm) segment – repeat endoscopy in 2–3 years
- If there has been previous low-grade dysplasia, see low-grade dysplasia protocol.
- Seattle protocol—biopsy of any mucosal irregularity and quadrantic biopsies every 2 cm unless known or suspected dysplasia then quadrantic biopsies every 1 cm.
Indefinite for dysplasia on biopsy
The changes of indefinite for dysplasia on biopsy should be confirmed by a second pathologist, ideally an expert gastrointestinal pathologist. If indefinite for dysplasia is confirmed, then the following endoscopic surveillance is recommended:
- Repeat endoscopy in 6 months with Seattle protocol biopsies for suspected dysplasia (biopsy of any mucosal irregularity and quadrantic biopsies every 1 cm) on maximal acid suppression
- If repeat shows no dysplasia, then follow as per non-dysplastic protocol
- If repeat shows low-grade or high-grade dysplasia or adenocarcinoma, then follow protocols for these respective conditions
- If repeat again shows confirmed indefinite for dysplasia, then repeat endoscopy in 6 months with Seattle protocol biopsies for suspected dysplasia
Low-grade dysplasia on biopsy
The changes of low-grade dysplasia on biopsy should be confirmed by a second pathologist, ideally an expert gastrointestinal pathologist. If low-grade dysplasia is confirmed, then the following endoscopic surveillance is recommended (or refer to an expert centre for assessment):
- Repeat endoscopy every 6 months with Seattle protocol biopsies for dysplasia (biopsy of any mucosal irregularity and quadrantic biopsies every 1 cm).
- If 2 consecutive 6-monthly endoscopies with Seattle dysplasia biopsy protocol show no dysplasia, then consider reverting to a less frequent follow up schedule.
High-grade dysplasia or adenocarcinoma on biopsy
Referral to a centre that has integrated expertise in endoscopy, imaging, surgery and histopathology.
Referral requirements
A referral may be rejected without the following information.
Send referral
Hotline: 1300 364 938
Fax: 1300 364 952
Electronic: eReferral system
Mail: Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
Health pathways
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