title: Evaluation of French guidelines on the indications of colonoscopy: results of a regional practice survey.
abstract: OBJECTIVE
  Compliance with guidelines on colonoscopic indications can improve colorectal cancer screening efficiency. We conducted a regional practice survey of gastroenterologists working in the public and private sectors in France, and compared the results with French national guidelines.
  
  
  METHODS
  Four consecutive yearly questionnaire-based practice surveys were conducted, and remedial measures were recommended on the basis of the results.
  
  
  RESULTS
  We analyzed 5128 colonoscopies carried out by 65 practitioners. Of these, 4266 (83.2%) conformed to contemporary guidelines, 391 (7.6%) did not conform, and 471 (9.2%) could not be classified, owing to a lack of information. Remedial measures led to a significant increase in the number of colonoscopies conforming to guidelines (p=0.037) and to a significant fall in the number of unclassified procedures (p=0.0018). The distribution of colonic lesions differed between procedures that did and did not conform to guidelines (2.4% versus 0.3% of colorectal cancers, 11.4% vs. 6.9% of advanced adenomas, and 17.5% vs. 14.6% of non-advanced adenomas; p<0.0001).
  
  
  CONCLUSIONS
  This longitudinal multicenter survey shows that national colonoscopy guidelines are largely respected in France and improve the detection of colonic neoplasia. Practices improved following implementation of remedial measures.
authors.affiliation: Hepatogastroenterology Unit, University Hospital, 2, rue de La-Milétrie, 86000 Poitiers, France. albanmichaud@gmail.com
authors.forename: Alban
authors.initials: A
authors.lastname: Michaud-Herbst
authors.forename: Vianney
authors.initials: V
authors.lastname: Jouhet
authors.forename: Pierre
authors.initials: P
authors.lastname: Ingrand
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Letard
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Dupuychaffray
authors.forename: Thierry
authors.initials: T
authors.lastname: Barrioz
authors.forename: Michel
authors.initials: M
authors.lastname: Beauchant
mesh_terms: D003113:Colonoscopy / Q000592:standards*; D005602:France; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D010818:Practice Patterns, Physicians'