P1756 - Provider Recommendation Adjustment to 2020 US Multi-Society Task Force on Colorectal Cancer Guidelines for Surveillance After Colonoscopy with Polypectomy for 3-4 Non-Advanced Adenomas

Katherine Scholand, MD¹, Wyatt Tarter, MS², Camille Hochheimer, PhD², Colleen Long, MD¹, Gregory L. Austin, MD, MPH³, Benjamin E. Cassell, MD^4
1University of Colorado, Denver, CO; ²Colorado School of Public Health, Aurora, CO; ³University of Colorado, Aurora, CO; ⁴University of Colorado School of Medicine, Aurora, CO

Introduction: The US Multi-Society Task Force on Colorectal Cancer updated its guidelines on surveillance following polypectomy in early 2020. For patients who underwent polypectomy of 3 to 4 small adenomas (< 10mm), the recommendation was changed from surveillance colonoscopy at 3 years to 3 to 5 years. We sought to assess the rate at which providers were changing their recommendation from 3 years to 3-5 years and 5 years.

Methods: This was a retrospective cohort study of consecutive colonoscopies performed at 3 UCHealth facilities, including the academic medical center. Average risk screening colonoscopies with 3-4 small adenomas were included from 2/6/2020-6/30/2021. Patient age, gender, 3 vs 4 adenomas removed, and size of the largest polyp were all assessed.

Results: During the studied time, there were 88 procedures with 3-4 tubular adenomas. There was 95% overall adherence with the surveillance interval of 3-5 years. Twenty two of the 88 received a surveillance recommendation of either 3-5 (n=3) or 5 (n=19) years. We assessed whether any patient or polyp factors were associated with receiving a surveillance interval of 3 years compared to 3-5 or 5 years. Patient age, gender, number of polyps (3 vs 4), and size of the largest polyp did not impact the final surveillance recommendation interval in a multinomial logistic regression analysis.

Discussion: While 95% of surveillance intervals remained within guideline recommendations for 3-4 small tubular adenomas, a majority of providers kept with a conservative recommendation of 3 years (69%), which is also in line with the prior 2012 guidelines. This in contrast to our recent published review of adherence to the new guidelines for 1-2 small adenomas, which showed 84% overall compliance with the new guidelines shifting to a longer interval of surveillance of 7-10 years from 5 years(1). This suggests that our providers may prefer to remain conservative in recommendations for surveillance intervals as long as it continues to remain in guidelines.

Disclosures:


Katherine Scholand, MD¹, Wyatt Tarter, MS², Camille Hochheimer, PhD², Colleen Long, MD¹, Gregory L. Austin, MD, MPH³, Benjamin E. Cassell, MD⁴. P1756 - Provider Recommendation Adjustment to 2020 US Multi-Society Task Force on Colorectal Cancer Guidelines for Surveillance After Colonoscopy with Polypectomy for 3-4 Non-Advanced Adenomas, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.