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PWE-120 Stricter Adherence to Surveillance Colonoscopy Guidelines for Colorectal Adenomas Could Result in Reduced Burden on Endoscopy Services
  1. AC Chircop1,
  2. S Chetcuti Zammit1,
  3. J Gerada1,
  4. A Brincat2
  1. 1Gastroenterology, Mater Dei Hospital, Msida, Malta
  2. 2Gastroenterology Department, Mater Dei Hospital, Malta

Abstract

Introduction International guidelines recommend repeating surveillance colonoscopy in patients with colonic adenomas. We aimed to study local adherence to such guidelines.

Methods Patients diagnosed with colonic adenomas between March and August 2008 were enrolled. Surveillance colonoscopy following adenoma removal was audited against the British Society of Gastroenterology guidelines: repeat in 5 years or no follow-up in low risk patients, repeat in 3 years in intermediate risk patients and repeat in 1 year in high risk patients.

Results 165 patients (61.8% males; mean age 62.1) were risk stratified as per guidelines. 95 patients (57.6%) were low risk, 61 (37%) intermediate risk, and 9 (5.4%) high risk. In the low risk group, 43 patients (45%) had surveillance either ≥5 years or never and 52 (55%) had a shorter follow up. In the intermediate risk group, 9 (14.8%) patients had surveillance at 3 years, 28 (45.9%) patients before 3 years, 8 (13.1%) patients after 3 years and 16 (26.2%) patients had no follow up colonoscopy. In the high risk group, 5 (55.6%) patients had surveillance at 1 year, 1 (11.1%) patient before 1 year, 2 (22.2%) patients after 1 year and 1 (11.1%) patient had no follow up colonoscopy. 2 patients (1.2%) were diagnosed with interval colon cancer in the same year as the index colonoscopy.

Conclusion Guideline non-adherence was noted in 65.5%, mainly due to too aggressive surveillance (49.1% early colonoscopies), increasing burden on endoscopy services. Late colonoscopies (6.1%) or no follow up colonoscopies (10.3%) were not the cause for interval cancers.

Disclosure of Interest None Declared

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