'How compliant do we want to be with the colonoscopy surveillance guidelines?'

Area of Science:

• Gastroenterology
• Clinical Practice Guidelines
• Colorectal Cancer Screening

Background:

• Surveillance colonoscopy is crucial for managing patients at high risk of colorectal cancer.
• Established guidelines from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG) provide a framework for optimal patient management.
• Understanding current clinical practice in relation to these guidelines is essential for identifying areas for improvement.

Purpose of the Study:

• To evaluate the adherence of clinicians to existing ACPGBI and BSG guidelines for surveillance colonoscopy referrals.
• To identify specific clinical scenarios where deviations from recommended surveillance practices occur.

Main Methods:

• A cross-sectional survey was conducted using a questionnaire distributed to members of the ACPGBI.
• Data were collected on referral practices for surveillance colonoscopy and reasons for any deviations from established guidelines.

Main Results:

• A response rate of 49% was achieved, with 195 clinicians providing data on their referral habits.
• While guidelines are generally accepted, a significant majority of clinicians reported deviating from them in specific clinical situations.
• Only 18% of surveyed clinicians reported complete adherence to all recommendations for surveillance colonoscopy in patients with a history of polyps, previous cancers, or a relevant family history.

Conclusions:

• The ACPGBI and BSG guidelines for surveillance colonoscopy are widely recognized and accepted by clinicians.
• Despite acceptance, substantial deviations from these guidelines are common in clinical practice, particularly for specific patient profiles.
• There is a clear need to address the discrepancy between recommended best practices and actual clinical application to ensure optimal patient outcomes in colorectal cancer surveillance.