Background and Aims
Overuse of screening colonoscopy increases cost and procedural adverse events, but
inadequate surveillance can miss the development of colorectal cancer. We measured
compliance with the 2020 U.S. Multi-Society Task Force on Colorectal Cancer (USMSTF)
polypectomy surveillance guidelines in clinical records and a survey.
Methods
We performed a retrospective study comparing surveillance intervals for first-time
average-risk colonoscopies with the 2020 USMSTF guidelines. Cases were analyzed from
3 intervals (March 2021 to May 2021, November 2021 to January 2022, and April 2022
to May 2022), collectively termed the postguideline period, and a baseline period
from November 2019 to January 2020. Real-world compliance rates were compared with
results of a survey conducted between November 2020 and February 2021.
Results
Overall compliance was 48.9% among 532 colonoscopies, ranging from 8.3% for low-risk
adenomas (LRAs), 88.3% for high-risk adenomas, 63.1% for sessile serrated polyps (SSPs),
and 88.6% for hyperplastic polyps. Compliance for LRA increased from the baseline
period (.8% vs 8.3%, P = .003), and 95.3% of nonadherent LRA cases followed the 2012 USMSTF guidelines.
Compliance for LRAs was 18.6% among respondents who provided a compliant surveillance
interval for LRAs in the survey. Noncompliance was associated with finishing training
>10 years ago (odds ratio, 1.9; 95% confidence interval, 1.4-2.7) and performing over
800 colonoscopies annually (odds ratio, 2.0; 95% confidence interval, 1.5-2.6).
Conclusions
Adoption of the 2020 USMSTF surveillance guidelines remains low at 2 years. Further
research into outcomes for patients with LRAs and SSPs may increase guideline adoption.
Abbreviations:
CRC (colorectal cancer), HP (hyperplastic polyp), HRA (high-risk adenoma), LRA (low-risk adenoma), SSP (sessile serrated polyp), TA (tubular adenoma), USMSTF (U.S. Multi-Society Task Force on Colorectal Cancer)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 20, 2022
Accepted:
August 13,
2022
Received:
May 12,
2022
Footnotes
DISCLOSURE: All authors disclosed no financial relationships.
Identification
Copyright
© 2023 by the American Society for Gastrointestinal Endoscopy
