Adherence to recommended intervals for surveillance colonoscopy in average-risk patients with 1 to 2 small (<1 cm) polyps on screening colonoscopy - 15/03/14
Abstract |
Background |
Among average-risk patients, repeat colonoscopy in 5 years is recommended after 1 to 2 small (<1 cm) adenomas are found on screening colonoscopy or in 10 years if hyperplastic polyps are found. However, sparse quantitative data are available about adherence to these recommendations or factors that may improve adherence.
Objective |
To quantify adherence to recommended intervals and to identify factors associated with lack of adherence.
Design |
Retrospective endoscopic database analysis.
Setting |
Tertiary-care institution and Veterans Affairs Health System.
Patients |
Average-risk individuals undergoing screening colonoscopy found to have 1 to 2 small polyps on screening colonoscopy.
Main Outcome Measurements |
Frequency of recommending repeat colonoscopy in 5 years if 1 to 2 small adenomas are found and in 10 years if hyperplastic polyps are found.
Results |
Of 922 outpatient screening colonoscopies with 1 to 2 small polyps found, 90.2% received appropriate recommendations for timing of repeat colonoscopy. Eighty-four percent of patients with 1 to 2 small adenomas and 94% of patients with 1 to 2 hyperplastic polyps received recommendations that were consistent with guidelines. Based on logistic regression analysis, patients aged >70 years (odds ratio [OR] 2.4, 95% confidence interval [CI], 1.0-5.7), fair bowel preparation (OR 12.7; 95% CI, 7.3-22.4), poor bowel preparation (OR 10.0; 95% CI, 4.3-23.6), and the presence of 2 small adenomas versus 1 small adenoma (OR 3.6; 95% CI, 2.2-6.0) were factors associated with “overuse” or recommendations inconsistent with guidelines.
Limitations |
Retrospective study design.
Conclusion |
More than 90% of endoscopists' recommendations for timing of surveillance colonoscopy in average-risk patients with 1 to 2 small polyps are consistent with guideline recommendations. Quality of preparation is strongly associated with deviation from guideline recommendations.
Le texte complet de cet article est disponible en PDF.Abbreviations : BMI, CRC, CMS, VAHCS
Plan
| DISCLOSURE: P. Schoenfeld is supported by a National Institutes of Health Mid-Career Mentoring Award (1K24DK084208-01A1). Dr. Schoenfeld has worked as a consultant and advisory board member for Salix Pharmaceuticals, Inc. All other authors disclosed no financial relationships relevant to this publication. |
|
| If you would like to chat with an author of this article, you may contact Dr Menees at sbartnik@med.umich.edu. |
Vol 79 - N° 4
P. 551-557 - avril 2014 Retour au numéro
Article précédent
- Gastrodiscoides hominis infestation of colon: endoscopic appearance
- Amit Gupte, Chirag Shah, Avani Koticha, Akash Shukla, Sunil Kuyare, Shobna Bhatia
- Detection of pharyngeal cancer in the overall population undergoing upper GI endoscopy by using narrow-band imaging: a single-center experience, 2009–2012
- Hiroyoshi Nakanishi, Hisashi Doyama, Kenichi Takemura, Naohiro Yoshida, Kunihiro Tsuji, Yasuhito Takeda, Yoshiro Asahina, Yosuke Kito, Renma Ito, Tomoyuki Hayashi, Katsura Hirano, Yoshinori Goto, Kei Tominaga, Satoko Inagaki, Yohei Waseda, Shigetsugu Tsuji, Kazuhiro Miwa, Yoshibumi Kaneko, Shinya Yamada, Hiroshi Kurumaya, Makoto Sakumoto, Toshihide Okada
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?