title: Awareness of surveillance recommendations among patients with colorectal adenomas.
abstract: OBJECTIVE
  The efficacy of colorectal cancer screening programs depends on the rate of attendance at surveillance colonoscopy examinations. Increasing patients' awareness about the importance of surveillance might improve attendance, but it is not clear how much they know about their follow-up recommendations. We assessed the awareness of patients with adenomas about their surveillance recommendations.
  
  
  METHODS
  Ten endoscopy departments provided access to their colonoscopy database for quality assurance; 2 datasets were obtained. We analyzed data from 4000 colonoscopies (400 per department) performed on patients with adenomas. All the patients were mailed a survey to determine how much information they had about their colonoscopy results and their follow-up recommendations. Data from 549 patients were included in the analysis. We also assessed surveillance attendance among 500 patients (50 per department) who had adenomas removed.
  
  
  RESULTS
  Of the patients analyzed, 85% recalled retrieval of polyps during their colonoscopy, and 85% recalled whether they needed surveillance or not. The indication for surveillance was recalled by 69% of patients (range between departments, 55%-83%; P < .01). Factors that were associated with awareness of recommendations were younger age (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.06-1.09), treatment by a gastroenterologist (OR, 5.53; 95% CI, 3.28-9.32), and presence of 3 or more adenomas (OR, 2.97; 95% CI, 1.29-6.85). Attendance among patients with adenomas varied among departments, from 60% to 89% (P < .01), and was not associated with awareness of patients about their recommendations per department (P = .59).
  
  
  CONCLUSIONS
  Not enough patients (only 85%) who receive colonoscopies are aware of their results or surveillance recommendations. Although awareness of findings and recommendations did not correlate with follow-up attendance, patients should be better informed about findings and their need for surveillance.
authors.affiliation: Department of Gastroenterology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. j.sintnicolaas@erasmusmc.nl
authors.forename: Jerome
authors.initials: J
authors.lastname: Sint Nicolaas
authors.forename: Vincent
authors.initials: V
authors.lastname: de Jonge
authors.forename: Djuna L
authors.initials: DL
authors.lastname: Cahen
authors.forename: Rob J Th
authors.initials: RJ
authors.lastname: Ouwendijk
authors.forename: Thjon J
authors.initials: TJ
authors.lastname: Tang
authors.forename: Antonie J P
authors.initials: AJ
authors.lastname: van Tilburg
authors.forename: Monique E
authors.initials: ME
authors.lastname: van Leerdam
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Kuipers
mesh_terms: D000236:Adenoma / Q000175:diagnosis*; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires