Who to refer to the New Zealand Familial Gastrointestinal Cancer Service
If your patient has any of the following:
- A family history of Familial Adenomatous Polyposis (FAP), Lynch Syndrome or other familial GI cancer syndromes
- A pathogenic variant (mutation carrier) of a hereditary GI cancer syndrome
- One first-degree relative plus two or more first- or second-degree relatives all on the same side of the family with a diagnosis of CRC at any age
- Two first-degree relatives, or one first-degree relative plus one or more second degree relatives, all on the same side of the family with a diagnosis of CRC and one such relative:
- was diagnosed with colorectal cancer aged 54 years or under, OR
- developed multiple bowel cancers, OR
- developed an extracolonic tumour suggestive of Lynch Syndrome (i.e., endometrial, ovarian, stomach, small bowel, renal pelvis, pancreas or brain)
- At least one first– or second-degree family member diagnosed with CRC in association with multiple bowel polyps
- A personal history or one first-degree relative with CRC diagnosed under the age of 50, particularly where colorectal tumour immunohistochemistry has revealed loss of protein expression for one of the mismatch repair genes (MLH1, MSH2, MSH6 and PMS2)
- A personal history or one first-degree relative with multiple colonic polyps as per Page 10 of Health New Zealand's Polyp Surveillance Guidelines
- A personal of family history of gastric cancer which meets the International Gastric Cancer Linkage Consortium (IGCLC)'s guidelines as outlined on Page 3
- Is a member of a family known to the New Zealand Familial Gastrointestinal Cancer Service
How to refer to the New Zealand Familial Gastrointestinal Cancer Service
Complete the form below, ensuring all mandatory fields are filled in, and email to NZFGCS@adhb.govt.nz
NZ Familial Gastrointestinal Cancer Referral Form
Patient eligibility
The New Zealand Familial Gastrointestinal Cancer Service is funded by Te Whatu Ora.
Click the following link to check your patient's eligibility to accessing publicly funded health services in New Zealand: Eligibility Criteria