P0367 - Adherence to Recommended Surveillance Colonoscopy Intervals in Average Risk Patients: Experience From a Tertiary Care Center

Samuel Cheong, DO¹, Mahak Chauhan, MD¹, Amar Vedamurthy, MD², Avin Aggarwal, MBBS^3
1Banner University Medical Center, Tucson, AZ; ²Banner Health, Tucson, AZ; ³University of Arizona College of Medicine, Tucson, AZ

Introduction: While colonoscopy is an effective screening tool to reduce colorectal cancer (CRC) mortality, literature review suggests variability in recommendations for follow up colonoscopy after the initial procedure. Despite effective screening and polyp surveillance, shorter intervals for colonoscopies can increase cost and risk for the patients (1). We aimed to assess physicians’ adherence to guideline-recommended surveillance intervals based on index colonoscopy findings at a tertiary care center.

Methods: We identified average risk patients who underwent screening or surveillance colonoscopy, had a high-quality exam with cecal intubation and adequate bowel preparation. A chart review was performed to identify the number of polyps, and a pathology report to confirm neoplasia detection.

Results: A total of 316 patients were identified; 296 met the criteria and 20 did not have a follow-up recommendation due to age or other comorbidities. Among patients with no polyps, the median time for subsequent screening exam was 10 years, with a range of 3 to 10 years despite adequate preparation for colonoscopy. Patients with low-risk adenomatous polyps; 1-2 tubular adenomas (TA) received a median follow-up of 5 years, two years earlier than recommended guidelines and those with 3-4 TA had a median follow up of 3 years, which was the lower limit of the recommended interval. Although the data was limited in sample size, the surveillance interval was again variable in patients with advanced adenomas but tended to be earlier than the standard guidelines.

Discussion: In a tertiary care academic center, endoscopists recommended a repeat colonoscopy earlier than guidelines for more than two-thirds of patients with low-risk adenomatous polyps. Additionally, among patients without pathology, the appropriate 10-year colonoscopy interval was recommended for only 83.4% patients. While factors associated with such an approach could be variable, compliance with recommended guidelines could reduce overuse of colonoscopy and associated healthcare costs.

Reference:

Johnson, Marcus R et al. “Physician Non-adherence to Colonoscopy Interval Guidelines in the Veterans Affairs Healthcare System.” Gastroenterology vol. 149,4 (2015): 938-51.



Disclosures:


Samuel Cheong, DO¹, Mahak Chauhan, MD¹, Amar Vedamurthy, MD², Avin Aggarwal, MBBS³. P0367 - Adherence to Recommended Surveillance Colonoscopy Intervals in Average Risk Patients: Experience From a Tertiary Care Center, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.