Awareness of postpolypectomy surveillance guidelines: A nationwide survey of colonoscopists in Canada

H van Kooten, V de Jonge, E Schreuders, et al. Awareness of postpolypectomy surveillance guidelines: A nationwide survey of colonoscopists in Canada. Can J Gastroenterol 2012;26(2):79-84. INTRODUCTION: Due to the increasing demand for colonoscopy, adherence to postpolypectomy surveillance guidelines is important. Suboptimal compliance can lead to unnecessary risks and ineffective use of resources. OBJECTIVE: To determine the awareness of and adherence to postpolypectomy surveillance guidelines among members of the Canadian Association of Gastroenterology (CAG). METHODS: A survey describing 14 clinical cases was mailed to all physician members (n = 411) of the CAG. Respondents were required to recommend a surveillance interval and a reason for his or her choice. RESULTS: A total of 150 colonoscopists (37%) completed the survey. Adherence to the guidelines varied from 23% to 96% per clinical scenario (median 63%). Recommended surveillance intervals were too short in 0% to 60% of the different cases (median 8%). The recommended interval was most often (60%) too short for a patient with one tubular adenoma with high-grade dysplasia. Surveillance intervals were too long in 4% to 75% of the cases (median 9%). The recommended interval was most often too long CONCLUSIONS: Compliance to colonoscopy surveillance guidelines is suboptimal and reflects both overuse and underuse. The results show that awareness about the content of guidelines needs to be raised and strategies implemented to increase adherence.