Non-compliance in surveillance for patients with previous resection of large (> or = 1 cm) colorectal adenomas.
OBJECTIVE
To assess the extent and reasons of non-compliance in surveillance for patients undergoing polypectomy of large (> or = 1 cm) colorectal adenomas.


METHODS
Between 1995 and 2002, colorectal adenomas > or = 1 cm were diagnosed in 210 patients and subsequently documented at the Erlangen Registry of Colorectal Polyps. One hundred and fifty-eight patients (75.2%) could be contacted by telephone and agreed to be interviewed. Additionally, records were obtained from the treating physicians.


RESULTS
Fifty-four out of 158 patients (34.2%) neglected any surveillance. Reasons for non-compliance included lack of knowledge concerning surveillance intervals (45.8%), no symptoms (29.2%), fear of examination (18.8%) or old age/severe illness (6.3%). In a multivariate analysis, the factors including female gender (P = 0.036) and age > 62 years (P = 0.016) proved to be significantly associated with non-compliance in surveillance.


CONCLUSIONS
Efforts to increase compliance in surveillance are of utmost importance. This applies particularly to women's compliance. Effective strategies for avoiding metachronous colorectal adenoma and cancer should focus on both the improvement in awareness and knowledge of patients and information about physicians for surveillance.
Brueckl
Wolfgang-M
WM
Department of Medicine 1, University Hospital of Erlangen, Ulmenweg 18, 91054 Erlangen, Germany. wolfgang.brueckl@med1.imed.uni-erlangen.de
Fritsche
Berit
B
Seifert
Brigitte
B
Boxberger
Frank
F
Albrecht
Heinz
H
Croner
Roland-S
RS
Wein
Axel
A
Hahn
Eckhart-G
EG
D000236:Adenoma / Q000523:psychology* / Q000601:surgery*; D001294:Attitude to Health; D003111:Colonic Polyps / Q000523:psychology* / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000523:psychology* / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D010349:Patient Compliance; D010817:Physician-Patient Relations