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J Clin Gastroenterol. 2009 Jul;43(6):554-8. doi: 10.1097/MCG.0b013e31818242ad.

Why don't gastroenterologists follow colon polyp surveillance guidelines?: results of a national survey.

Author information

1
Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, MI 48109-0362, USA. sdsaini@umich.edu

Abstract

GOALS:

To measure knowledge and acceptance of colon polyp surveillance guidelines among gastroenterologists.

BACKGROUND:

Gastroenterologists often perform surveillance colonoscopy sooner than recommended by guidelines. Lack of knowledge may be an important factor, but gastroenterologists could also simply disagree with guideline recommendations.

STUDY:

A 24-item multiple-choice survey was developed from the 2003 multisociety colorectal cancer screening and surveillance guideline. The survey was distributed to practicing gastroenterologists preparing for the gastroenterology board recertification examination at 2 major national gastroenterology board review courses. For each question, subjects were given a clinical scenario and asked: (1) the guideline recommendation for the scenario; (2) their usual practice in the scenario; and, (3) if they definitely knew the recommendation or were simply guessing at the correct answer. If a respondent knew the recommendation but differed in their usual practice, this was considered disagreement with the recommendation.

RESULTS:

The survey was completed by 57.1% (116/203) of gastroenterologists preparing for 2004 recertification. Seventy-eight percent reported that they were familiar with the 2003 guideline, though only 57% reported that guidelines were "very influential" in their practice. Many did not correctly answer questions on the recommended interval for hyperplastic polyps (12%), 2 small adenomas (36%), 3 small adenomas (49%), and adenoma with high-grade dysplasia (41%). Of gastroenterologists who knew the guideline recommendations, up to 76% disagreed with the recommendations and chose to perform surveillance sooner than recommended.

CONCLUSIONS:

Though many gastroenterologists lack knowledge about guideline recommendations for colon polyp surveillance, even those who know the recommendations often ignore them and perform surveillance colonoscopy sooner than recommended.

PMID:
19542818
DOI:
10.1097/MCG.0b013e31818242ad
[Indexed for MEDLINE]
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