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Implementation of BSG/ACPGBI/PHE polypectomy surveillance guidelines safely reduces the burden of surveillance in a screening cohort: a virtual model study

OBJECTIVE: To evaluate the impact of British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England (BSG/ACPGBI/PHE) 2019 polypectomy surveillance guidelines within a national faecal immunochemical test-based bowel cancer screening (BS) cohort on...

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Autores principales: Stack, Roisin, Doherty, Jayne, O'Moráin, Neil, Nolan, Blathnaid, Sheridan, Juliette, Cullen, Garret, Mulcahy, Hugh, Buckley, Maire, Horgan, Gareth, Hamed, Mohamed, McDermott, Edel, Doherty, Glen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503359/
https://www.ncbi.nlm.nih.gov/pubmed/37699732
http://dx.doi.org/10.1136/bmjgast-2023-001160
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author Stack, Roisin
Doherty, Jayne
O'Moráin, Neil
Nolan, Blathnaid
Sheridan, Juliette
Cullen, Garret
Mulcahy, Hugh
Buckley, Maire
Horgan, Gareth
Hamed, Mohamed
McDermott, Edel
Doherty, Glen
author_facet Stack, Roisin
Doherty, Jayne
O'Moráin, Neil
Nolan, Blathnaid
Sheridan, Juliette
Cullen, Garret
Mulcahy, Hugh
Buckley, Maire
Horgan, Gareth
Hamed, Mohamed
McDermott, Edel
Doherty, Glen
author_sort Stack, Roisin
collection PubMed
description OBJECTIVE: To evaluate the impact of British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England (BSG/ACPGBI/PHE) 2019 polypectomy surveillance guidelines within a national faecal immunochemical test-based bowel cancer screening (BS) cohort on surveillance activity and detection of pathology by retrospective virtual application. DESIGN: A retrospective review of BS colonoscopies performed in 2015–2016 with 5 years prospective follow-up in single institution. Index colonoscopies were selected. Incomplete colonoscopies were excluded. Histology of all resected polyps was reviewed. Surveillance intervals were calculated according to BSG/ACPGBI/PHE 2019 guidelines and compared with pre-existing ‘European Guidelines for Quality Assurance in Colorectal Cancer Screening and Diagnosis’ (EUQA 2013). Total number of colonoscopies deferred by virtual implementation of BSG/ACPGBI/PHE 2019 guidelines were calculated. Pathology identified on procedures that would have been deferred was reviewed. RESULTS: Total number of index BS colonoscopies performed in 2015–2016 inclusive was 890. 115 were excluded (22 no caecal intubation, 51 inadequate bowel preparation, 56 incomplete polyp clearance). N=509 colonoscopies were scheduled within a 5-year interval following index colonoscopy surveillance rounds based on EUQA guidelines. Overall, volume of surveillance was significantly reduced with retrospective application of BSG/ACPGBI/PHE 2019 guidelines (n=221, p<0.0001). No cancers were detected within the ‘potentially deferred’ procedures who attended for follow-up (n=330) with high-risk findings found in<10% (n=30) of colonoscopies within the BSG/ACPGBI/PHE cohort. CONCLUSION: BSG/ACPGBI/PHE 2019 guidelines safely reduce the burden of colonoscopy demand with acceptable pathology findings on deferred colonoscopies.
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spelling pubmed-105033592023-09-16 Implementation of BSG/ACPGBI/PHE polypectomy surveillance guidelines safely reduces the burden of surveillance in a screening cohort: a virtual model study Stack, Roisin Doherty, Jayne O'Moráin, Neil Nolan, Blathnaid Sheridan, Juliette Cullen, Garret Mulcahy, Hugh Buckley, Maire Horgan, Gareth Hamed, Mohamed McDermott, Edel Doherty, Glen BMJ Open Gastroenterol Endoscopy OBJECTIVE: To evaluate the impact of British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England (BSG/ACPGBI/PHE) 2019 polypectomy surveillance guidelines within a national faecal immunochemical test-based bowel cancer screening (BS) cohort on surveillance activity and detection of pathology by retrospective virtual application. DESIGN: A retrospective review of BS colonoscopies performed in 2015–2016 with 5 years prospective follow-up in single institution. Index colonoscopies were selected. Incomplete colonoscopies were excluded. Histology of all resected polyps was reviewed. Surveillance intervals were calculated according to BSG/ACPGBI/PHE 2019 guidelines and compared with pre-existing ‘European Guidelines for Quality Assurance in Colorectal Cancer Screening and Diagnosis’ (EUQA 2013). Total number of colonoscopies deferred by virtual implementation of BSG/ACPGBI/PHE 2019 guidelines were calculated. Pathology identified on procedures that would have been deferred was reviewed. RESULTS: Total number of index BS colonoscopies performed in 2015–2016 inclusive was 890. 115 were excluded (22 no caecal intubation, 51 inadequate bowel preparation, 56 incomplete polyp clearance). N=509 colonoscopies were scheduled within a 5-year interval following index colonoscopy surveillance rounds based on EUQA guidelines. Overall, volume of surveillance was significantly reduced with retrospective application of BSG/ACPGBI/PHE 2019 guidelines (n=221, p<0.0001). No cancers were detected within the ‘potentially deferred’ procedures who attended for follow-up (n=330) with high-risk findings found in<10% (n=30) of colonoscopies within the BSG/ACPGBI/PHE cohort. CONCLUSION: BSG/ACPGBI/PHE 2019 guidelines safely reduce the burden of colonoscopy demand with acceptable pathology findings on deferred colonoscopies. BMJ Publishing Group 2023-09-12 /pmc/articles/PMC10503359/ /pubmed/37699732 http://dx.doi.org/10.1136/bmjgast-2023-001160 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Endoscopy
Stack, Roisin
Doherty, Jayne
O'Moráin, Neil
Nolan, Blathnaid
Sheridan, Juliette
Cullen, Garret
Mulcahy, Hugh
Buckley, Maire
Horgan, Gareth
Hamed, Mohamed
McDermott, Edel
Doherty, Glen
Implementation of BSG/ACPGBI/PHE polypectomy surveillance guidelines safely reduces the burden of surveillance in a screening cohort: a virtual model study
title Implementation of BSG/ACPGBI/PHE polypectomy surveillance guidelines safely reduces the burden of surveillance in a screening cohort: a virtual model study
title_full Implementation of BSG/ACPGBI/PHE polypectomy surveillance guidelines safely reduces the burden of surveillance in a screening cohort: a virtual model study
title_fullStr Implementation of BSG/ACPGBI/PHE polypectomy surveillance guidelines safely reduces the burden of surveillance in a screening cohort: a virtual model study
title_full_unstemmed Implementation of BSG/ACPGBI/PHE polypectomy surveillance guidelines safely reduces the burden of surveillance in a screening cohort: a virtual model study
title_short Implementation of BSG/ACPGBI/PHE polypectomy surveillance guidelines safely reduces the burden of surveillance in a screening cohort: a virtual model study
title_sort implementation of bsg/acpgbi/phe polypectomy surveillance guidelines safely reduces the burden of surveillance in a screening cohort: a virtual model study
topic Endoscopy
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503359/
https://www.ncbi.nlm.nih.gov/pubmed/37699732
http://dx.doi.org/10.1136/bmjgast-2023-001160
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