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Physician Perceptions of Surveillance Follow-up Colonoscopy in Older Adults

Stephanie T Le¹, Brenna R Lash¹, Paul C Schroy¹

¹From the Department of Internal Medicine (STL) and the Section of Gastroenterology (BRL, PCS, AHC), Boston Medical Center, Boston, MA; and the Section of Gastroenterology, Dartmouth-Hitchcock Medical Center, Lebanon, NH (AHC).

Journal of the American Board of Family Medicine : JABFM

|May 10, 2017

Abstract

Background:

Few data exist regarding when to stop surveillance colonoscopy among older adults with a history of adenomatous colorectal polyps. Our goal was to understand decision making around surveillance colonoscopy among primary care providers (PCPs) and gastroenterologists.

Methods:

We designed a 15-item survey for PCPs and gastroenterologists that evaluated factors important in decision making about surveillance colonoscopy in older adults.

Results:

In October 2015, 88 PCPs and 30 gastroenterologists completed the survey. Life expectancy (40%), gastroenterology recommendation (8%), and patient preference (12%) were the most important factors for PCPs. Findings on prior colonoscopy were most important among gastroenterologists. Regardless of specialty, respondents felt that the existing literature on surveillance colonoscopy in older adults is inadequate.

Conclusions:

More data surrounding the benefits and risk of surveillance colonoscopy are needed to inform when to stop surveillance colonoscopy among older adults with a positive screening history.

Keywords:

Adenomatous Polyps Colonoscopy Colorectal Cancer Gastroenterology Primary Health Care Surveys and Questionnaires

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