title: The appropriateness of surveillance colonoscopy intervals after polypectomy.
abstract: BACKGROUND
  Adherence to surveillance colonoscopy guidelines is important to prevent colorectal cancer (CRC) and unnecessary workload.
  
  
  OBJECTIVE
  To evaluate how well Canadian gastroenterologists adhere to colonoscopy surveillance guidelines after adenoma removal or treatment for CRC.
  
  
  METHODS
  Patients with a history of adenomas or CRC who had surveillance performed between October 2008 and October 2010 were retrospectively included. Time intervals between index colonoscopy and surveillance were compared with the 2008 guideline recommendations of the American Gastroenterological Association and regarded as appropriate when the surveillance interval was within six months of the recommended time interval.
  
  
  RESULTS
  A total of 265 patients were included (52% men; mean age 58 years). Among patients with a normal index colonoscopy (n=110), 42% received surveillance on time, 38% too early (median difference = 1.2 years too early) and 20% too late (median difference = 1.0 year too late). Among patients with nonadvanced adenomas at index (n=96), 25% underwent surveillance on time, 61% too early (median difference = 1.85) and 14% too late (median difference = 1.1). Among patients with advanced neoplasia at index (n=59), 29% underwent surveillance on time, 34% too early (median difference = 1.86) and 37% later than recommended (median difference = 1.61). No significant difference in adenoma detection rates was observed when too early surveillance versus appropriate surveillance (34% versus 33%; P=0.92) and too late surveillance versus appropriate surveillance (21% versus 33%; P=0.11) were compared.
  
  
  CONCLUSIONS
  Only a minority of surveillance colonoscopies were performed according to guideline recommendations. Deviation from the guidelines did not improve the adenoma detection rate. Interventions aimed at improving adherence to surveillance guidelines are needed.
authors: Department of Gastronenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. elineschreuders@gmail.com
authors: Eline
authors: E
authors: Schreuders
authors: Jerome
authors: J
authors: Sint Nicolaas
authors: Vincent
authors: V
authors: de Jonge
authors: Harmke
authors: H
authors: van Kooten
authors: Isaac
authors: I
authors: Soo
authors: Daniel
authors: D
authors: Sadowski
authors: Clarence
authors: C
authors: Wong
authors: Monique E
authors: ME
authors: van Leerdam
authors: Ernst J
authors: EJ
authors: Kuipers
authors: Sander J O
authors: SJ
authors: Veldhuyzen van Zanten
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D000368:Aged; D002170:Canada; D003111:Colonic Polyps / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003113:Colonoscopy / Q000379:methods* / Q000592:standards; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D005260:Female; D005762:Gastroenterology / Q000592:standards; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D013997:Time Factors
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