Post-polypectomy surveillance colonoscopy: are we following the guidelines?
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Post-polypectomy surveillance colonoscopy: are we following the guidelines? N. Abu Freha 1 & M. Abu Tailakh 2 & J. Elkrinawi 1 & H. Abu Kaf 1 & A. Philip 3 & D. Schwartz 1 & A. Yahia 1 & O. Etzion 1 Accepted: 3 March 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Polyps are a common finding on colonoscopy procedures. After completing polypectomy, patients are to be followed up with endoscopy. The purpose of the study was to assess the adherence of gastroenterologists to international post-polypectomy guidelines. Methods Israeli gastroenterologists answered a questionnaire, consisting of 30 items, regarding the recommendation for postpolypectomy surveillance following colonoscopy. Results One hundred and twelve gastroenterologists, representing 23% of the total number of Israeli gastroenterologists, participated in this study, by responding to the web-based questionnaire (mean age is 47 ± 10 years, males, 74 (66%)). From the total responses, 57.4% were compatible with the updated European post-polypectomy guidelines. The recommendations appeared remarkably inappropriate when applied to polyps that were identified as having low-risk tubular adenoma, tubular adenoma with high-grade dysplasia, and small serrated adenoma. In 37.2% of questionnaires, the recommended time to follow-up colonoscopy was shorter than currently stated in the guidelines. The appropriate polypectomy technique was chosen by 62% of the responses. Gastroenterologists younger than 45 years of age adhered more strongly to the international guidelines, particularly in cases of piecemeal polypectomy or high-risk adenoma polypectomy. Conclusions Gastroenterologists follow the clinical guidelines for post-polypectomy surveillance intervals partially. 57.4% of the recommendations were compatible with the guidelines, whereas 37% of the recommendations were for shorter interval. Keywords Adherence . Polyps . Follow-up . Gastroenterologist . Clinical guidelines
Background Colorectal cancer (CRC) is a common cancer in the Western population. In general, CRC developed from previous adenoma, the adenoma-carcinoma sequence, which requires years to develop into sporadic CRC. Reduction of CRC incidence and mortality can be achieved as a result of adenoma removal [1]. * N. Abu Freha [email protected]; [email protected] 1
The Institute of Gastroenterology and Hepatology, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
2
Recanati School for Community Health Professions, Department of Nursing, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
3
Medical School for International Health, Ben-Gurion University, Beer-Sheva, Israel
Both removal of precancerous adenomatous polyps at the time of the index colonoscopy and early detection of curative CRC reduce CRC incidence and mortality [2]. Patients who undergo removal of polyps should be followed post-procedure accor
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