1. Rates of repeated colonoscopies to clean the colon from low-risk and high-risk adenomas: results from the EPoS trials
- Author
-
Frederik Emil Juul, Kjetil Garborg, Eugen Nesbakken, Magnus Løberg, Paulina Wieszczy, Joaquín Cubiella, Mette Kalager, Michael F Kaminski, Rune Erichsen, Hans-Olov Adami, Monika Ferlitsch, Siv K B Furholm, Ann G Zauber, Enrique Quintero, Marek Bugajski, Øyvind Holme, Evelien Dekker, Rodrigo Jover, Michael Bretthauer, Gastroenterology and Hepatology, CCA - Cancer Treatment and Quality of Life, CCA - Imaging and biomarkers, and Amsterdam Gastroenterology Endocrinology Metabolism
- Subjects
COLONOSCOPY ,POLYP ,ENDOSCOPIC POLYPECTOMY ,SURVEILLANCE ,Gastroenterology - Abstract
ObjectiveHigh-quality colonoscopy (adequate bowel preparation, whole-colon visualisation and removal of all neoplastic polyps) is a prerequisite to start polyp surveillance, and is ideally achieved in one colonoscopy. In a large multinational polyp surveillance trial, we aimed to investigate clinical practice variation in number of colonoscopies needed to enrol patients with low-risk and high-risk adenomas in polyp surveillance.DesignWe retrieved data of all patients with low-risk adenomas (one or two tubular adenomas ResultsThe study comprised 15 581 patients from 38 endoscopy centres in five European countries; 6794 patients had low-risk and 8787 had high-risk adenomas. 961 patients (6.2%, 95% CI 5.8% to 6.6%) underwent two or more colonoscopies before surveillance began; 101 (1.5%, 95% CI 1.2% to 1.8%) in the low-risk group and 860 (9.8%, 95% CI 9.2% to 10.4%) in the high-risk group. Main reasons were poor bowel preparation (21.3%) or incomplete colonoscopy/polypectomy (14.4%) or planned second procedure (27.8%). Need of repeat colonoscopy varied between study centres ranging from 0% to 11.8% in low-risk adenoma patients and from 0% to 63.9% in high-risk adenoma patients. On the second colonoscopy, the two most common reasons for a repeat (third) colonoscopy were piecemeal resection (26.5%) and unspecified reason (23.9%).ConclusionThere is considerable practice variation in the number of colonoscopies performed to achieve complete polyp removal, indicating need for targeted quality improvement to reduce patient burden.Trial registration numberNCT02319928.
- Published
- 2022