Show simple item record

dc.contributor.authorvan Heijningen, E.
dc.contributor.authorLansdorp-Vogelaar, Iris
dc.contributor.authorSteyerberg, E.
dc.contributor.authorGoede, S.
dc.contributor.authorDekker, E.
dc.contributor.authorLesterhuis, W.
dc.contributor.authorter Borg, F.
dc.contributor.authorVecht, J.
dc.contributor.authorSpoelstra, P.
dc.contributor.authorEngels, L.
dc.contributor.authorBolwerk, C.
dc.contributor.authorTimmer, R.
dc.contributor.authorKleibeuker, J.
dc.contributor.authorKoornstra, J.
dc.contributor.authorde Koning, H.
dc.contributor.authorKuipers, E.
dc.contributor.authorvan Ballegooijen, M.
dc.date.accessioned2017-03-15T22:17:27Z
dc.date.available2017-03-15T22:17:27Z
dc.date.created2017-02-26T19:31:38Z
dc.date.issued2015
dc.identifier.citationvan Heijningen, E. and Lansdorp-Vogelaar, I. and Steyerberg, E. and Goede, S. and Dekker, E. and Lesterhuis, W. and ter Borg, F. et al. 2015. Adherence to surveillance guidelines after removal of colorectal adenomas: A large, community-based study. Gut. 64 (10: 1584-1592.
dc.identifier.urihttp://hdl.handle.net/20.500.11937/50116
dc.identifier.doi10.1136/gutjnl-2013-306453
dc.description.abstract

Objective: To determine adherence to recommended surveillance intervals in clinical practice. Design: 2997 successive patients with a first adenoma diagnosis (57% male, mean age 59 years) from 10 hospitals, who underwent colonoscopy between 1998 and 2002, were identified via Pathologisch Anatomisch Landelijk Geautomatiseerd Archief: Dutch Pathology Registry. Their medical records were reviewed until 1 December 2008. Time to and findings at first surveillance colonoscopy were assessed. A surveillance colonoscopy occurring within ±3 months of a 1-year recommended interval and ±6 months of a recommended interval of 2 years or longer was considered appropriate. The analysis was stratified by period per change in guideline (before 2002: 2-3 years for patients with 1 adenoma, annually otherwise; in 2002: 6 years for 1-2 adenomas, 3 years otherwise). We also assessed differences in adenoma and colorectal cancer recurrence rates by surveillance timing. Results: Surveillance was inappropriate in 76% and 89% of patients diagnosed before 2002 and in 2002, respectively. Patients eligible under the pre-2002 guideline mainly received surveillance too late or were absent (57% of cases). For patients eligible under the 2002 guideline surveillance occurred mainly too early (48%). The rate of advanced neoplasia at surveillance was higher in patients with delayed surveillance compared with those with too early or appropriate timed surveillance (8% vs 4-5%, <0.01). Conclusions: There is much room for improving surveillance practice. Less than 25% of patients with adenoma receive appropriate surveillance. Such practice seriously hampers the effectiveness and efficiency of surveillance, as too early surveillance poses a considerable burden on available resources while delayed surveillance is associated with an increased rate of advanced adenoma and especially colorectal cancer.

dc.rights.urihttp://creativecommons.org/licenses/by-nc/3.0/
dc.titleAdherence to surveillance guidelines after removal of colorectal adenomas: A large, community-based study
dc.typeJournal Article
dcterms.source.issn0017-5749
dcterms.source.titleGut
curtin.accessStatusOpen access


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record

http://creativecommons.org/licenses/by-nc/3.0/
Except where otherwise noted, this item's license is described as http://creativecommons.org/licenses/by-nc/3.0/