Adherence to colorectal polyp surveillance guidelines: is there a 'scope' to increase the opportunities for screening?

Hdl Handle:
http://hdl.handle.net/10147/207939
Title:
Adherence to colorectal polyp surveillance guidelines: is there a 'scope' to increase the opportunities for screening?
Authors:
O'Connor, Anthony; Keane, Ruth-Anne; Egan, Brian; Lee, Nikki; O'Connor, Humphrey; Qasim, Asghar; Ryan, Barbara; Breslin, Niall; McNamara, Deirdre; O'Morain, Colm
Affiliation:
Department of Gastroenterology, Adelaide and Meath Hospital incorporating the, National Children's Hospital/Trinity College Dublin, Ireland. oconna12@tcd.ie
Citation:
Eur J Cancer Prev. 2011 Jan;20(1):40-5.
Journal:
European journal of cancer prevention : the official journal of the European, Cancer Prevention Organisation (ECP)
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207939
DOI:
10.1097/CEJ.0b013e32833ecc5f
PubMed ID:
20975566
Abstract:
Colorectal polyps are usually asymptomatic and are found opportunistically. Individuals with adenomata are at increased risk for cancer and therefore guidelines exist for surveillance of these lesions including those of the British Society of Gastroenterology (BSG). Deviation from these guidelines is common and increases the workload of endoscopy. We examined those individuals waiting for endoscopy for polyp surveillance to see whether strict adherence to BSG guidelines could facilitate opportunities for screening. A total of 413 patients with earlier colonic polyps were examined, of whom 50 patients were excluded based on having alternative indications for surveillance, 179 (49.3%) were appropriately scheduled for surveillance and 184 patients (55.9%) were scheduled incorrectly. Seventy-nine patients (30%) could have been discharged; of these, 59 had hyperplastic polyps. Of the remaining 105 inappropriate triages under surveillance at the wrong interval, seven patients were scheduled for too infrequent surveillance and 98 were too frequent. A total of 284 patients with adenomatous polyps were under surveillance of whom 11 patients (3.8%) were in the high-risk category and all were appropriately scheduled, and 75 patients (26.4%) were in the intermediate-risk category, of whom 48 were appropriately scheduled, 20 were incorrectly triaged as high risk and seven were triaged as low risk. A total of 198 (69.7%) patients were in the low-risk category, 117 of these were correctly triaged, 15 were incorrectly triaged as high risk and 66 were classified as intermediate risk. Over a five-year period, 318 unnecessary colonoscopies are being performed. On the basis of the data obtained from a population-based colorectal screening programme using immunohistochemical-faecal occult blood testing in our department another 1516 patients could be screened annually without requiring any additional endoscopy resources, if strict adherence to guidelines was assured.
Language:
eng
MeSH:
Adenomatous Polyps/diagnosis; Colonic Polyps/*diagnosis; Colonoscopy/*standards/statistics & numerical data; Early Detection of Cancer; Great Britain; *Guideline Adherence; Humans; *Population Surveillance; Practice Guidelines as Topic; Risk Assessment; Unnecessary Procedures
ISSN:
1473-5709 (Electronic); 0959-8278 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorO'Connor, Anthonyen_GB
dc.contributor.authorKeane, Ruth-Anneen_GB
dc.contributor.authorEgan, Brianen_GB
dc.contributor.authorLee, Nikkien_GB
dc.contributor.authorO'Connor, Humphreyen_GB
dc.contributor.authorQasim, Asgharen_GB
dc.contributor.authorRyan, Barbaraen_GB
dc.contributor.authorBreslin, Niallen_GB
dc.contributor.authorMcNamara, Deirdreen_GB
dc.contributor.authorO'Morain, Colmen_GB
dc.date.accessioned2012-02-01T10:50:40Z-
dc.date.available2012-02-01T10:50:40Z-
dc.date.issued2012-02-01T10:50:40Z-
dc.identifier.citationEur J Cancer Prev. 2011 Jan;20(1):40-5.en_GB
dc.identifier.issn1473-5709 (Electronic)en_GB
dc.identifier.issn0959-8278 (Linking)en_GB
dc.identifier.pmid20975566en_GB
dc.identifier.doi10.1097/CEJ.0b013e32833ecc5fen_GB
dc.identifier.urihttp://hdl.handle.net/10147/207939-
dc.description.abstractColorectal polyps are usually asymptomatic and are found opportunistically. Individuals with adenomata are at increased risk for cancer and therefore guidelines exist for surveillance of these lesions including those of the British Society of Gastroenterology (BSG). Deviation from these guidelines is common and increases the workload of endoscopy. We examined those individuals waiting for endoscopy for polyp surveillance to see whether strict adherence to BSG guidelines could facilitate opportunities for screening. A total of 413 patients with earlier colonic polyps were examined, of whom 50 patients were excluded based on having alternative indications for surveillance, 179 (49.3%) were appropriately scheduled for surveillance and 184 patients (55.9%) were scheduled incorrectly. Seventy-nine patients (30%) could have been discharged; of these, 59 had hyperplastic polyps. Of the remaining 105 inappropriate triages under surveillance at the wrong interval, seven patients were scheduled for too infrequent surveillance and 98 were too frequent. A total of 284 patients with adenomatous polyps were under surveillance of whom 11 patients (3.8%) were in the high-risk category and all were appropriately scheduled, and 75 patients (26.4%) were in the intermediate-risk category, of whom 48 were appropriately scheduled, 20 were incorrectly triaged as high risk and seven were triaged as low risk. A total of 198 (69.7%) patients were in the low-risk category, 117 of these were correctly triaged, 15 were incorrectly triaged as high risk and 66 were classified as intermediate risk. Over a five-year period, 318 unnecessary colonoscopies are being performed. On the basis of the data obtained from a population-based colorectal screening programme using immunohistochemical-faecal occult blood testing in our department another 1516 patients could be screened annually without requiring any additional endoscopy resources, if strict adherence to guidelines was assured.en_GB
dc.language.isoengen_GB
dc.subject.meshAdenomatous Polyps/diagnosisen_GB
dc.subject.meshColonic Polyps/*diagnosisen_GB
dc.subject.meshColonoscopy/*standards/statistics & numerical dataen_GB
dc.subject.meshEarly Detection of Canceren_GB
dc.subject.meshGreat Britainen_GB
dc.subject.mesh*Guideline Adherenceen_GB
dc.subject.meshHumansen_GB
dc.subject.mesh*Population Surveillanceen_GB
dc.subject.meshPractice Guidelines as Topicen_GB
dc.subject.meshRisk Assessmenten_GB
dc.subject.meshUnnecessary Proceduresen_GB
dc.titleAdherence to colorectal polyp surveillance guidelines: is there a 'scope' to increase the opportunities for screening?en_GB
dc.contributor.departmentDepartment of Gastroenterology, Adelaide and Meath Hospital incorporating the, National Children's Hospital/Trinity College Dublin, Ireland. oconna12@tcd.ieen_GB
dc.identifier.journalEuropean journal of cancer prevention : the official journal of the European, Cancer Prevention Organisation (ECP)en_GB
dc.description.provinceLeinster-

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