Gut Liver.  2018 Jul;12(4):426-432. 10.5009/gnl17403.

Guideline Adherence to Colonoscopic Surveillance Intervals after Polypectomy in Korea: Results from a Nationwide Survey

Affiliations
  • 1National Cancer Control Institute, Goyang, Korea. jkjun@ncc.re.kr
  • 2Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
  • 3Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
  • 4Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 5Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.

Abstract

BACKGROUND/AIMS
People around the world are increasingly choosing to undergo colorectal cancer screening via colonoscopy. As a result, guideline adherence to postpolypectomy colonoscopy surveillance has drawn increasing attention. The present study was performed to assess recognition and adherence to guidelines among primary care physicians and gastroenterologists and to identify characteristics associated with compliance.
METHODS
A nationwide sample of primary care physicians employed at cancer screening facilities and registered members of the Korean Society of Gastrointestinal Endoscopy were recruited. Participants were asked to complete a survey of six hypothetical clinical scenarios designed to assess their potential course of action in response to screening or follow-up colonoscopy results. Frequencies and odds ratios and 95% confidence intervals for guideline adherence were estimated.
RESULTS
The proportions of doctors recommending shortened colonoscopy surveillance intervals for low- and high-risk adenomas were greater than 90% among primary physicians and were much lower among gastroenterologists. Guideline adherence was relatively good among groups of doctors who were young, had a specialty in gastroenterology, worked at tertiary hospitals, and cared for an appropriate number of patients.
CONCLUSIONS
The present study reveals a remaining discrepancy between practitioner recommendations and current guidelines for postpolypectomy surveillance. Several factors were shown to be related to guideline adherence, suggesting a need for appropriate control and continuing education or training programs among particular groups of practitioners.

Keyword

Colonoscopy; Guideline adherence; Colorectal neoplasms; Early detection of cancer

MeSH Terms

Adenoma
Colonoscopy
Colorectal Neoplasms
Compliance
Early Detection of Cancer
Education
Education, Continuing
Endoscopy, Gastrointestinal
Follow-Up Studies
Gastroenterology
Guideline Adherence*
Humans
Korea*
Mass Screening
Odds Ratio
Physicians, Primary Care
Tertiary Care Centers
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