Adherence to 2020 US Multi-Society Task Force Guidelines for Post-Polypectomy Surveillance: a Multicenter Real-Time...

Area of Science:

• Gastroenterology
• Endoscopy
• Preventive Medicine

Background:

• The U.S. Multi-Society Task Force (USMSTF) issued updated guidelines in 2020 recommending less frequent post-polypectomy surveillance.
• Despite updated guidelines, premature colonoscopies and suboptimal adherence to surveillance intervals persist.
• This study investigates adherence trends and influencing factors five years after the 2020 guideline release.

Purpose of the Study:

• To evaluate adherence to the 2020 USMSTF colonoscopy surveillance guidelines.
• To determine if adherence has improved over time since the guidelines were published.
• To identify factors associated with non-adherence to recommended surveillance intervals.

Main Methods:

• A multicenter retrospective cohort study included 452 patients undergoing their first surveillance colonoscopy between 2020 and 2025.
• Pathology findings from index and surveillance colonoscopies were analyzed, categorizing lesions as hyperplastic polyps (HPs), low-risk adenomas (LRAs), or high-risk adenomas (HRAs).
• Surveillance timing was classified as early or late if performed more than six months outside the recommended interval.

Main Results:

• Early surveillance occurred in 58% of first surveillance colonoscopies, while late surveillance occurred in 13%.
• Early surveillance was significantly more common for patients with only HPs (82%) and LRAs (64%).
• Patients with HRAs were more likely to experience delayed surveillance (OR 0.096). Early surveillance rates showed variability by year, increasing from 46% in 2020 to 60% in 2025.

Conclusions:

• Adherence to the 2020 USMSTF colonoscopy surveillance guidelines remains suboptimal five years post-publication.
• There are persistent gaps in the implementation of recommended post-polypectomy surveillance protocols.
• The findings underscore the need for improved strategies to ensure guideline adherence for optimal colorectal cancer prevention.