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Canadian Journal of Gastroenterology - Volume 27 2013, Issue 1, Pages 33-38

Original Article

Departments of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands

Division of Gastroenterology, University of Alberta Hospital, Edmonton, Alberta, Canada

Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands

Received 17 November 2011; Accepted 24 June 2012

Copyright © 2013 Hindawi Publishing Corporation. This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License CC BY-NC, which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes.


BACKGROUND: Adherence to surveillance colonoscopy guidelines is important to prevent colorectal cancer CRC and unnecessary workload.

OBJECTIVE: To evaluate how well Canadian gastroenterologists adhere to colonoscopy surveillance guidelines after adenoma removal or treatment for CRC.

METHODS: Patients with a history of adenomas or CRC who had surveillance performed between October 2008 and October 2010 were retrospectively included. Time intervals between index colonoscopy and surveillance were compared with the 2008 guideline recommendations of the American Gastroenterological Association and regarded as appropriate when the surveillance interval was within six months of the recommended time interval.

RESULTS: A total of 265 patients were included 52% men; mean age 58 years. Among patients with a normal index colonoscopy n=110, 42% received surveillance on time, 38% too early median difference = 1.2 years too early and 20% too late median difference = 1.0 year too late. Among patients with nonadvanced adenomas at index n=96, 25% underwent surveillance on time, 61% too early median difference = 1.85 and 14% too late median difference = 1.1. Among patients with advanced neoplasia at index n=59, 29% underwent surveillance on time, 34% too early median difference = 1.86 and 37% later than recommended median difference = 1.61. No significant difference in adenoma detection rates was observed when too early surveillance versus appropriate surveillance 34% versus 33%; P=0.92 and too late surveillance versus appropriate surveillance 21% versus 33%; P=0.11 were compared.

CONCLUSION: Only a minority of surveillance colonoscopies were performed according to guideline recommendations. Deviation from the guidelines did not improve the adenoma detection rate. Interventions aimed at improving adherence to surveillance guidelines are needed.

Autor: Eline Schreuders, Jerome Sint Nicolaas, Vincent de Jonge, Harmke van Kooten, Isaac Soo, Daniel Sadowski, Clarence Wong, Monique E



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