Surveillance colonoscopy for patients with moderate- and high-risk polyps as recommended by the 2020 US Multi-Society Task Force (USMSTF) is underused, according to a study presented at Digestive Disease Week 2022 in San Diego.

Researchers followed 16,804 patients who had undergone polypectomy at a screening colonoscopy to determine the use of surveillance colonoscopies in the Mass General Brigham Colonoscopy Cohort. They assessed the compliance, overuse, and underuse of post-polypectomy surveillance in patients with low-, moderate-, and high-risk index polyps. Of the patients, 59% were diagnosed with low-risk polyps, 10% with moderate-risk, and 31% with high-risk. At a median follow-up of 4.1 years, 80% of the patients (n = 13,431) had undergone a surveillance colonoscopy. The prevalence of surveillance colonoscopy was higher for those patients with low-risk polyps (88%) than those with moderate- (68%) or high-risk (69%).

According to the 2020 USMSTF, only 42% of total patients and 20% of patients with high-risk polyps were considered compliant. Surveillance colonoscopies was substantially overused among patients with low-risk polyps (34%) and underused among those with moderate- (40%) and high-risk (52%) polyps.

Older age (>60 years) and lower income (quartile 1 vs. quartile 4) were both associated with a higher prevalence of underuse. Family history of colorectal cancer, however, was associated with overuse. The researchers stated that “a tailored approach is needed to improve compliance without compromising risk attenuation.”

—Allison Casey

Reference:
Knudsen MD, Wang K, Berstad P, et al. Adherences to the 2020 US Multi-Society Task Force (USMSTF) recommendations for post-polypectomy surveillance colonoscopy. Poster presented at: Digestive Disease Week; May 21, 2022. San Diego, CA.