Recommendations for follow-up interval after colonoscopy with inadequate bowel preparation in a national colonoscopy quality registry - 14/01/22
Abstract |
Background and Aims |
Endoscopist recommendations regarding a repeat colonoscopy after inadequate bowel cleanliness have not been fully described. Our aim was to evaluate the timing of recommendations for repeat colonoscopy after inadequate bowel preparation using a large, national colonoscopy registry.
Methods |
We performed a cross-sectional analysis of all outpatient screening and surveillance colonoscopies among adults ages 50 to 75 reported in the GI Quality Improvement Consortium from 2011 to 2018. The primary outcome was a recommendation to repeat colonoscopy within 1 year. Secondary outcomes were recommendations based on indication of colonoscopy and colonoscopy findings and predictors of a recommendation to follow-up within 1 year.
Results |
There were 260,314 colonoscopies with inadequate bowel preparation performed at 672 different sites by 4001 endoscopists. Of these, 31.9% contained a recommendation for follow-up within 1 year. This did not differ meaningfully by examination indication. The severity of colonoscopy findings influenced the recommendations for follow-up (within 1 year in 84.0% of cases with adenocarcinoma, 51.8% with any advanced lesion, and 23.2% with 1-2 small adenomas). Younger age, more severe pathology, location in the Northeast, and performance by an endoscopist with an adenoma detection rate ≥25% were associated with recommendations for follow-up within 1 year.
Conclusions |
Only some colonoscopies with inadequate bowel preparation are recommended to be repeated within 1 year, which may have implications for potential missed lesions. Further understanding of reasons driving recommendations is an important next step to improving guideline-concordant colonoscopy practice.
Le texte complet de cet article est disponible en PDF.Abbreviations : ADR, ASA, GIQuIC, USMSTF
Plan
| DISCLOSURE: The following author received research support for this study from the National Cancer Institute (R21 CA227776), The Dartmouth-Hitchcock Cancer Research Fellows Program, the National Cancer Institute Cancer Center Support Grant (5P30CA023108) to the Dartmouth-Hitchcock Norris Cotton Cancer Center, and The Dartmouth Clinical and Translational Science Institute (award no. UL1TR001086) from the National Center for Advancing Translational Sciences of the National Institutes of Health: A. H. Calderwood. All other authors disclosed no financial relationships. |
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| See CME section, p. 372. |
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| If you would like to chat with an author of this article, you may contact Dr Calderwood at audrey.h.calderwood@hitchcock.org. |
Vol 95 - N° 2
P. 360 - février 2022 Retour au numéro
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