There has been an increase in the use of colonoscopy for colorectal cancer screening and surveillance of colorectal adenomas after polypectomy in the United States.
This has given rise to concerns about the availability of endoscopic resources.
The current guidelines recommend surveillance after polypectomy at 3 to 5 years for a small adenoma. Follow-up is not recommended for hyperplastic polyps.
However, the intensity of physicians' surveillance is not known.
|24% of gastroenterologists and 54% of surgeons recommend surveillance for a hyperplastic polyp.|
|Annals of Internal Medicine|
In this study, researchers surveyed practicing gastroenterologists and general surgeons about their perceived need for the frequency of surveillance after polypectomy.
They compared the survey responses to current practice guidelines, and identified factors influencing the physicians' recommendations for surveillance.
The team surveyed 349 gastroenterologists and 316 general surgeons using a questionnaire.
Overall, the response rate for the questionnaire was 83%.
The researchers found that 24% of gastroenterologists and 54% of surgeons recommend surveillance for a hyperplastic polyp.
Furthermore, most physicians recommended surveillance colonoscopy for small adenomas. More than 50% recommended examinations every 3 years or more often.
The physicians indicated that published evidence was very influential in their practice.
However, the team found that only half of the physicians stated that the guidelines were very influential.
Dr Pauline Mysliwiec and colleagues concluded, "Some surveillance colonoscopy seems to be inappropriately performed and in excess of guidelines, particularly for hyperplastic polyps and low-risk lesions such as a small adenoma".
"These results suggest unnecessary demand for endoscopic resources".