Schreuders Eline, Sint Nicolaas Jerome, de Jonge Vincent, van Kooten Harmke, Soo Isaac, Sadowski Daniel, Wong Clarence, van Leerdam Monique E, Kuipers Ernst J, Veldhuyzen van Zanten Sander J O
Department of Gastronenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Can J Gastroenterol. 2013 Jan;27(1):33-8. doi: 10.1155/2013/279897.
Adherence to surveillance colonoscopy guidelines is important to prevent colorectal cancer (CRC) and unnecessary workload.
To evaluate how well Canadian gastroenterologists adhere to colonoscopy surveillance guidelines after adenoma removal or treatment for CRC.
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.
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.
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.
遵守结肠镜监测指南对于预防结直肠癌（CRC）和避免不必要的工作量很重要。
评估加拿大胃肠病学家在腺瘤切除或CRC治疗后遵守结肠镜监测指南的情况。
回顾性纳入2008年10月至2010年10月期间进行监测的有腺瘤或CRC病史的患者。将初次结肠镜检查与监测之间的时间间隔与美国胃肠病学会2008年指南建议进行比较，当监测间隔在推荐时间间隔的六个月内时视为合适。
共纳入265例患者（52%为男性；平均年龄58岁）。在初次结肠镜检查正常的患者（n = 110）中，42%按时接受监测，38%过早（中位差异为过早1.2年），20%过晚（中位差异为过晚1.0年）。在初次检查为非进展性腺瘤的患者（n = 96）中，25%按时接受监测，61%过早（中位差异 = 1.85），14%过晚（中位差异 = 1.1）。在初次检查为进展期肿瘤的患者（n = 59）中，29%按时接受监测，34%过早（中位差异 = 1.86），37%晚于推荐时间（中位差异 = 1.61）。比较过早监测与适当监测（34%对33%；P = 0.92）以及过晚监测与适当监测（21%对33%；P = 0.11）时，腺瘤检出率无显著差异。
只有少数结肠镜监测是根据指南建议进行的。偏离指南并未提高腺瘤检出率。需要采取干预措施以提高对监测指南的遵守情况。
