Real-world compliance with the 2020 U.S. Multi-Society Task Force on Colorectal Cancer polypectomy surveillance...

Area of Science:

• Gastroenterology
• Oncology
• Public Health

Background:

• Screening colonoscopies carry risks and costs; inadequate surveillance can lead to missed colorectal cancer.
• The 2020 U.S. Multi-Society Task Force on Colorectal Cancer (USMSTF) updated polypectomy surveillance guidelines.

Purpose of the Study:

• To measure compliance with the 2020 USMSTF polypectomy surveillance guidelines.
• To compare real-world compliance rates with survey data.

Main Methods:

• Retrospective study comparing surveillance intervals for first-time average-risk colonoscopies against 2020 USMSTF guidelines.
• Analysis of clinical records from baseline (Nov 2019-Jan 2020) and post-guideline periods (Mar 2021-May 2022).
• Comparison of real-world compliance with survey data (Nov 2020-Feb 2021).

Main Results:

• Overall compliance was 48.9% across 532 colonoscopies.
• Compliance varied significantly: 8.3% for low-risk adenomas (LRAs), 88.3% for high-risk adenomas, 63.1% for sessile serrated polyps (SSPs), and 88.6% for hyperplastic polyps.
• Noncompliance was linked to endoscopists completing training over 10 years prior or performing >800 colonoscopies annually.

Conclusions:

• Two years post-publication, adoption of the 2020 USMSTF surveillance guidelines remains low.
• Compliance for LRAs improved from baseline but remained low (8.3%).
• Further research on patient outcomes for LRAs and SSPs may improve guideline adherence.