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Colorectal cancer surgery patients receive surveillance colonoscopies earlier than recommended by guidelines

Many patients who undergo surgery for colorectal cancer receive surveillance colonoscopies earlier than recommended by guidelines, reports the latest issue of Clinical Gastroenterology & Hepatology.

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Patients treated with surgery for colorectal cancer should undergo colonoscopy examinations 1, 4, and 9 years later, to check for cancer recurrence.

Dr Amanpal Singh from Texas, USA investigated the use patterns of surveillance colonoscopies among Medicare patients.

The team used the Surveillance, Epidemiology and End Results–Medicare linked database to identify patients who underwent curative surgery for colorectal cancer from 1992 to 2005, and analyzed the timing of the first 3 colonoscopies after surgery.

Early surveillance colonoscopy was defined as a colonoscopy, for no reason other than surveillance, within 3 months to 2 years after a colonoscopy examination with normal results.

The research team noted that approximately 32% and 27% of patients with normal results from their first and second colonoscopies, respectively, underwent subsequent surveillance colonoscopies within 2 years.

24% underwent a repeat procedure within 2 years for no clear indication
Clinical Gastroenterology & Hepatology

Of patients who were older than 80 years at their first colonoscopy, 24% underwent a repeat procedure within 2 years for no clear indication.

The doctors found that early surveillance colonoscopy was not associated with sex, race, or patients' level of education.

There was significant regional variation in early surveillance colonoscopies among the Surveillance, Epidemiology, and End Results regions.

The researchers observed that there was a significant trend toward reduced occurrence of second early surveillance colonoscopies.

Dr Singh's team concluded, "Many Medicare enrollees who have undergone curative resection for colorectal cancer undergo surveillance colonoscopy more frequently than recommended by the guidelines."

"Reducing overuse could free limited resources for appropriate colonoscopy examinations of inadequately screened populations."

Clin Gastroenterol Hepatol 2012: 11(1) : 65-72


29 January 2013

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