P0355 - Addressing Updated Colorectal Cancer Surveillance Guidelines in a Post-Pandemic Environment

Bhavana Tetali, MD, Shanti Eswaran, MD, Elena Stoffel, MD, MPH, Tammy Ellies, MBA, Elizabeth Spranger, BA, Stacy B. Menees, MD, MS
University of Michigan, Ann Arbor, MI

Introduction: As we emerge from the COVID-19 pandemic, gastroenterology (GI) endoscopic centers have seen increased demand and increased wait times due to previously delayed procedures and decrease in recommended screening age. Coincidentally, the United States Multi-Society Task Force (USMSTF) published updated polypectomy surveillance guidelines in 2020 recommending lengthened intervals for surveillance colonoscopy based on the number and type of polyps. Applying these updated guidelines both prospectively and retrospectively may decrease the number of anticipated surveillance colonoscopies. The aims of this study are to quantify the proportion of patients with 1-2 low risk adenoma (LRA) previously who would meet criteria for a lengthened surveillance interval, and to describe colonoscopy findings in patients who completed their follow-up surveillance based on prior guidelines of 5 years for 1-2 LRA.

Methods: We performed a retrospective analysis of adult patients who were due for a surveillance colonoscopy in July 2022, approximately 5 years after prior colonoscopy, at an academic tertiary care center. The patient list was attained from the electronic medical records system. We collected data on demographics, bowel preparation adequacy, family history of CRC, and pathology results of prior and follow-up surveillance colonoscopy. Data were analyzed with descriptive statistics.

Results: 398 patients were included. Demographic data is available in Table 1. 35% of patients had 1-2 LRA approximately 5 years prior with adequate bowel preparation and no family history of CRC. 20% of these patients had undergone follow-up surveillance colonoscopy. Of these patients, 49% had a negative colonoscopy or small left-sided hyperplastic polyps, 33% had 1-2 LRA, 9% had 1-2 small sessile serrated polyps, 6% had 3-4 adenomas, 1% had 3-4 adenomas, and 1% had 5-10 adenomas on follow-up colonoscopy.

Discussion: Over 1 in 3 patients due for a surveillance colonoscopy could undergo a colonoscopy at 7 years instead of 5 years based on the 2020 USMSTF surveillance guidelines. The risks of a lengthened surveillance interval appear to be low with over 80% of patients having a negative colonoscopy, small left-sided hyperplastic polyps, or 1-2 LRA at follow-up endoscopy. GI endoscopic centers should consider retroactively applying the USMSTF guidelines to past patients to offset the post-pandemic procedure burden and to permit space for more urgent procedures.



Disclosures:


Bhavana Tetali, MD, Shanti Eswaran, MD, Elena Stoffel, MD, MPH, Tammy Ellies, MBA, Elizabeth Spranger, BA, Stacy B. Menees, MD, MS. P0355 - Addressing Updated Colorectal Cancer Surveillance Guidelines in a Post-Pandemic Environment, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.