Multi-Society Task Force Said to Repeat Colonoscopy Within One Year for Inadequate Preparation, but a Lot of Colonoscopists Aren’t
Douglas K. Rex, MD, MASGE, reviewing Calderwood AH, et al. Gastrointest Endosc 2021 Sep 22.
In 2015, the U.S. Multi-Society Task Force (MSTF) on Colorectal Cancer, composed of members of the 3 luminal GI societies, recommended that patients with inadequate bowel preparation undergo repeat colonoscopy within 1 year.
In an assessment of data from the GI Quality Improvement Consortium registry, there were 232,590 colonoscopies with inadequate preparation and follow-up recommendations. Of the colonoscopies, 64% were for screening and 36% for surveillance. The data came from 672 endoscopy sites in the U.S. Sixty-seven percent of endoscopists were GI doctors, and 54% had an adenoma detection rate (ADR) of ≥35%.
For inadequate preparation, a follow-up interval of within 1 year was recommended in 32% of all colonoscopies, including 61.3% incomplete colonoscopies (no cecal intubation) and 26.6% with cecal intubation. Predictors of a recommendation within 1 year were younger patient age, male patients, more advanced polyp findings or a finding of cancer, and procedures performed in the Northeast U.S. Endoscopists with a higher ADR were more likely than those with a lower ADR to recommend follow-up within 1 year, and gastroenterologists were less likely than nongastroenterologists to recommend follow-up within 1 year.
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COMMENTThe recommendation to follow up inadequate preparation with colonoscopy within 1 year has been firm for more than 6 years; therefore, the observed trends could reflect a lack of knowledge of the MSTF recommendation or disagreement with it. In general, gastroenterologists tend to recommend longer intervals after screening and surveillance than nongastroenterologists; the observations here are consistent with that trend rather than better knowledge of the MSTF recommendation.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Calderwood AH, Holub JL, Greenwald DA. Recommendations for follow-up interval after colonoscopy with inadequate bowel preparation in a national colonoscopy quality registry. Gastrointest Endosc 2021 Sep 22. (Epub ahead of print) (https://doi.org/10.1016/j.gie.2021.09.027)