Adherence to Surveillance Guidelines after the Removal of Colorectal Polyps: A Multinational, Multicenter, Prospective Survey
- Author:
Chang Kyo OH
1
;
Satimai ANIWAN
;
Panida PIYACHATURAWAT
;
Zhiqin WONG
;
Thida SOE
;
Bayasgalan LUVSANDAGVA
;
Quang Trung TRAN
;
Achmad FAUZI
;
Jeong-Sik BYEON
;
Young-Seok CHO
Author Information
- Publication Type:Original Article
- From:Gut and Liver 2021;15(6):878-886
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:As the number of colonoscopies and polypectomies performed continues to increase in many Asian countries, there is a great demand for surveillance colonoscopy. The aim of this study was to investigate the adherence to postpolypectomy surveillance guidelines among physicians in Asia.
Methods:A survey study was performed in seven Asian countries. An email invitation with a link to the survey was sent to participants who were asked to complete the questionnaire consisting of eight clinical scenarios.
Results:Of the 137 doctors invited, 123 (89.8%) provided valid responses. Approximately 50% of the participants adhered to the guidelines regardless of the risk of adenoma, except in the case of tubulovillous adenoma ≥10 mm combined with high-grade dysplasia, in which 35% of the participants adhered to the guidelines. The participants were stratified according to the number of colonoscopies performed: ≥20 colonoscopies per month (high volume group) and <20 colo-noscopies per month (low volume group). Higher adherence to the postpolypectomy surveillance guidelines was evident in the high volume group (60%) than in the low volume group (25%). The reasons for nonadherence included concern of missed polyps (59%), the low cost of colonoscopy (26%), concern of incomplete resection (25%), and concern of medical liability (15%).
Conclusions:A discrepancy between clinical practice and surveillance guidelines among physicians in Asia was found. Physicians in the low volume group frequently did not adhere to the guidelines, suggesting a need for continuing education and appropriate control. Concerns regarding the quality of colonoscopy and complete polypectomy were the main reasons for nonadherence.
