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Rate of Surveillance Colonoscopies After Diagnosis of Advanced Adenomas

By: Cordi Craig
Posted: Monday, February 4, 2019

Although experts recommend surveillance colonoscopy procedures 3 years after advanced adenoma removal to reduce colorectal cancer incidence and mortality, a population-based study found that the procedure was underutilized by patients as well as varied by health-care system, patient age, and number of adenomas found. Jessica Chubak, PhD, of the Kaiser Permanente Washington Health Research Institute, Seattle, and colleagues indicated that it is necessary to find “evidence-based interventions to improve the adherence to surveillance guidelines.” The study results were published in Cancer Epidemiology, Biomarkers & Prevention.

The investigators analyzed data from approximately 6,900 patients with at least 3 adenomas and/or at least a single adenoma with villous or tubulovillous histology in 4 integrated health-care delivery systems. The patients were between the ages of 50 and 89 years.

The percentage of patients undergoing subsequent colonoscopy between 6 months and 3.5 years after the discovery of advanced adenomas ranged from 18.3% to 59.5% across health-care systems. Patients with at least three adenomas were more likely to undergo subsequent colonoscopy than those with one or two villous or tubulovillous adenomas. The procedure was more common for patients between the ages of 60 and 74 years. The authors observed fewer procedures in older patients (80 to 89 years old) than younger patients (50 to 54 years old) at their index colonoscopy.

“Although we did not observe many associations between patient characteristics and receipt of subsequent colonoscopy, we recommend that future studies assessing the effectiveness of interventions to increase surveillance colonoscopy utilization evaluate intervention effectiveness in patient subgroups to try to ensure benefits and harms are equitable and health disparities are minimized,” the authors concluded. 

Disclosure: The study authors’ disclosure information can be found at

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