Colorectal Surveillance After Polypectomy
Objective: To survey practicing gastroenterologists and general surgeons about
their perceived need for the frequency of surveillance after polypectomy, to compare
survey responses to practice guidelines, and to identify factors influencing their
recommendations for surveillance.
rates were 83%. Among gastroenterologists (317 of 349) and surgeons (125 of 316) who
perform screening colonoscopy, 24% (95% CI, 19.3% to 28.7%) of gastroenterologists and 54%
(CI, 44.9% to 62.5%) of surgeons recommend surveillance for a hyperplastic polyp. For a
small adenoma, most physicians recommended surveillance colonoscopy and more than 50%
recommended examinations every 3 years or more often. Physicians indicated that published
evidence was very influential in their practice (83% [CI, 78.8% to 87.2%] of
gastroenterologists and 78% [CI, 72.5% to 86.8%] of surgeons). By contrast, only half of
respondents reported that guidelines were very influential.
Conclusions: Some surveillance
colonoscopy seems to be inappropriately performed and in excess of guidelines,
particularly for hyperplastic polyps and low-risk lesions such as a small adenoma. These
results suggest unnecessary demand for endoscopic resources.
Reference: Mysliwiec PA, Brown ML, Klabunde CN, Ransohoff DF.
Are physicians doing too much colonoscopy? A national survey of colorectal surveillance after polypectomy.
Ann Intern Med 2004;141(4):264-71.
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