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Implementation of BSG/ACPGBI/PHE polypectomy surveillance guidelines safely reduces the burden of surveillance in a screening cohort: a virtual model study. | LitMetric

AI Article Synopsis

  • The study aimed to assess the effectiveness of the BSG/ACPGBI/PHE 2019 polypectomy surveillance guidelines on bowel cancer screening and surveillance activity in a national cohort, using historical data from colonoscopies performed in 2015-2016.
  • The research involved a retrospective review of colonoscopy results, comparing the new guidelines with earlier European standards, and found a significant reduction in the number of necessary surveillance colonoscopies.
  • The conclusion drawn is that the implementation of the 2019 guidelines effectively decreases the demand for colonoscopies while maintaining acceptable levels of identified pathology in cases that were deferred for follow-up.

Article Abstract

Objective: To evaluate the impact of British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England (BSG/ACPGBI/PHE) 2019 polypectomy surveillance guidelines within a national faecal immunochemical test-based bowel cancer screening (BS) cohort on surveillance activity and detection of pathology by retrospective virtual application.

Design: A retrospective review of BS colonoscopies performed in 2015-2016 with 5 years prospective follow-up in single institution. Index colonoscopies were selected. Incomplete colonoscopies were excluded. Histology of all resected polyps was reviewed. Surveillance intervals were calculated according to BSG/ACPGBI/PHE 2019 guidelines and compared with pre-existing 'European Guidelines for Quality Assurance in Colorectal Cancer Screening and Diagnosis' (EUQA 2013). Total number of colonoscopies deferred by virtual implementation of BSG/ACPGBI/PHE 2019 guidelines were calculated. Pathology identified on procedures that would have been deferred was reviewed.

Results: Total number of index BS colonoscopies performed in 2015-2016 inclusive was 890. 115 were excluded (22 no caecal intubation, 51 inadequate bowel preparation, 56 incomplete polyp clearance). N=509 colonoscopies were scheduled within a 5-year interval following index colonoscopy surveillance rounds based on EUQA guidelines. Overall, volume of surveillance was significantly reduced with retrospective application of BSG/ACPGBI/PHE 2019 guidelines (n=221, p<0.0001). No cancers were detected within the 'potentially deferred' procedures who attended for follow-up (n=330) with high-risk findings found in<10% (n=30) of colonoscopies within the BSG/ACPGBI/PHE cohort.

Conclusion: BSG/ACPGBI/PHE 2019 guidelines safely reduce the burden of colonoscopy demand with acceptable pathology findings on deferred colonoscopies.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503359PMC
http://dx.doi.org/10.1136/bmjgast-2023-001160DOI Listing

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