Impact of Retroactive Application of Updated Surveillance Guidelines on Endoscopy Center Capacity at a Large VA...

In 2020, the US Multi-Society Task Force (USMSTF) on Colorectal Cancer revised its recommended interval for surveillance of 1 to 2 subcentimeter tubular adenomas from 5 to 10 years to 7 to 10 years. This study assessed the impact of retroactively applying these guidelines on endoscopy center capacity.

Colonoscopy reports were reviewed for patients with an upcoming colonoscopy reminder at the Veterans Affairs Pittsburgh Healthcare System (VAPHS). Patients with incomplete records, high-risk indications, or inadequate bowel preparation were excluded. Previous surveillance recommendations were compared with the 2020 USMSTF guideline to determine whether colonoscopy intervals could be extended.

Of 583 patients, 331 (56.7%) had adequate data to determine extendibility. Using the 2020 USMSTF guidelines, colonoscopy interval could be extended by ≥ 1 year for 64 patients (11%) for a total of 153 years extended. For 36 patients, the ability to extend the colonoscopy interval was directly attributable to the updated 2020 USMSTF guideline.

Retroactive application of USMSTF surveillance guidelines could modestly increase endoscopic capacity, but overall impact may be limited by fragmentation of care.