Large Overuse of Post-polypectomy Surveillance Colonoscopy

Large Overuse of Post-polypectomy Surveillance Colonoscopy: a Prospective Nation-wide Study

In colorectal cancer screening era a huge burden of medical resources has been applied to surveillance. Although the adherence to post-polipectomy recommendations is a advocated as a mainstay for quality assurance colonoscopy programs, prospective data on appropriateness of surveillance are lacking.

The aim of present study was to evaluate the percentage of subjects in which timing of surveillance colonoscopy in practice agrees with that recommended by guidelines and to identify factors associated to the appropriateness of surveillance.

Study Overview

• Status: Completed
• Conditions: Colonic Polyps; Colonoscopy; Surveillance
• Intervention / Treatment: Other: colonoscopy

• Study Type: Observational
• Enrollment (Actual): 7081

Contacts and Locations

Study Locations

• Italy
  • Como, Italy, 22100
    • Valduce Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

All patients referred to one out of 29 endoscopy units in Italy to undergo colonoscopy

Description

Inclusion Criteria:

• consecutive colonoscopy outpatients
• adults (18-80 yrs)

Exclusion Criteria:

• Subjects with missing data on polyp findings at previous colonoscopy (number, endoscopic or histological features)
• Subjects with unsatisfactory quality standards of previous examination (no cecal intubation, inadequate bowel preparation, incomplete polyp resection)
• patients with a medical history of inflammatory bowel disease, inherited or other polyposis syndrome and colorectal cancer.

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Colonoscopy patients; Consecutive colonoscopy outpatients referred to one of 29 endoscopy units in Italy	Other: colonoscopy; evaluation of surveillance timing adequacy as compared to the guidelines

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adherence to post-polypectomy surveillance guidelines	Time interval between index and surveillance colonoscopies for patients undergoing post-polypectomy surveillance was calculated and compared to that suggested by the guidelines according to endoscopic findings at previous examination. For each patiens, surveillance time interval was regarded as correct if coherent with the recommended interval +/- 6 months, thus allowing to calculate the proportion of correct prescriptions	up to one year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Factors associated to surveillance appropriateness	The presence of factors associated to appropriate surveillance prescriptions was investigated by multivariate analysis (odds ratio and 95% confidence interval for each factor)	up to one year

Collaborators and Investigators

• Sponsor: Valduce Hospital

Publications and helpful links

General Publications

• Radaelli F, Paggi S, Bortoli A, De Pretis G; Italian Association of Hospital Gastroenterologists (AIGO). Overutilization of post-polypectomy surveillance colonoscopy in clinical practice: a prospective, multicentre study. Dig Liver Dis. 2012 Sep;44(9):748-53. doi: 10.1016/j.dld.2012.04.015. Epub 2012 May 22.

Study record dates

Study Major Dates

• Study Start: July 1, 2010
• Primary Completion (Actual): January 1, 2011
• Study Completion (Actual): January 1, 2011

Study Registration Dates

• First Submitted: October 18, 2011
• First Submitted That Met QC Criteria: October 20, 2011
• First Posted (Estimate): October 24, 2011

Study Record Updates

• Last Update Posted (Estimate): October 24, 2011
• Last Update Submitted That Met QC Criteria: October 20, 2011
• Last Verified: October 1, 2011

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathological Conditions, Anatomical; Polyps; Intestinal Polyps; Colonic Polyps
• Other Study ID Numbers: SURV_2011