Adherence to colorectal polyp surveillance guidelines: is there a 'scope' to increase the opportunities for screening?
AffiliationDepartment of Gastroenterology, Adelaide and Meath Hospital incorporating the, National Children's Hospital/Trinity College Dublin, Ireland. email@example.com
Colonoscopy/*standards/statistics & numerical data
Early Detection of Cancer
Practice Guidelines as Topic
MetadataShow full item record
CitationEur J Cancer Prev. 2011 Jan;20(1):40-5.
JournalEuropean journal of cancer prevention : the official journal of the European, Cancer Prevention Organisation (ECP)
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.
- Follow up of patients with colorectal polyps: are the BSG guidelines being adhered to?
- Authors: Pickard M, Dewar EP, Kapadia RC, Khan RB, Hutchinson IF, Nejim A
- Issue date: 2007 Mar
- Physician Non-adherence to Colonoscopy Interval Guidelines in the Veterans Affairs Healthcare System.
- Authors: Johnson MR, Grubber J, Grambow SC, Maciejewski ML, Dunn-Thomas T, Provenzale D, Fisher DA
- Issue date: 2015 Oct
- Surveillance colonoscopies for colorectal polyps--too often, too many! An Audit at a Large District General Hospital.
- Authors: John BJ, Irukulla S, Pilgrim G, Swift I, Abulafi AM
- Issue date: 2008 Nov
- Assessment of adherence to published surveillance guidelines--opportunity to enhance efficiency of endoscopic practice.
- Authors: Harewood GC, Rathore O, Patchett S, Murray F
- Issue date: 2008 Sep
- Why don't gastroenterologists follow colon polyp surveillance guidelines?: results of a national survey.
- Authors: Saini SD, Nayak RS, Kuhn L, Schoenfeld P
- Issue date: 2009 Jul