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Surveillance colonoscopy recommendations for average-risk patients with 1 to 2 small polyps consistent with guidelines
Date:4/16/2014

ions inconsistent with guidelines.

This study adds to the growing body of research about why endoscopists recommend repeat colonoscopies sooner than indicated by guidelines. Endoscopists appear to recommend repeat colonoscopy sooner when bowel preparation is fair or worse because they are understandably concerned that small adenomas might have been missed. Other possible reasons for repeating colonoscopy sooner than recommended include if patients are at higher risk for CRC (ie, over 70 years old) or if the endoscopist is concerned about the limitations of colonoscopy to prevent CRC in the right side of the colon (i.e. recommend repeat colonoscopy sooner than five years if two small flat adenomas were found in the ascending colon). Some endoscopists simply may distrust research used to support guideline recommendations or be concerned about medicolegal issues. Ultimately, a combination of qualitative research with endoscopists and quantitative database research with endoscopist-specific characteristics needs to be conducted to clarify this topic.

The researchers stated that these findings provide a starting point to establish targets or benchmarks for frequency of adherence to guideline recommendations. This may contribute to the development of quality improvement programs and national benchmarks by organizations such as the Centers for Medicare & Medicaid Services. Fair bowel cleansing was strongly associated with recommendations inconsistent with guidelines. This suggests that interventions that improve the quality of bowel preparation may improve adherence to guideline recommendations.


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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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