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116 The surveillance interval of follow-up colonoscopy after an initial colonoscopy: a retrospective study
  1. Jun-Hung Lai1,
  2. Tsai-Wei Huang2,3
  1. 1Department of Internal Medicine, Erlin Christian Hospital, Changhua, Taiwan
  2. 2School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
  3. 3Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan


Background More and more people have undergone colonoscopy for colorectal cancer screening. The surveillance interval is up to the patients with low- or high-risk polyps at the first screening. According to the guideline of US Multi-Society Task Force on Colorectal Cancer, they recommend that the surveillance intervals for patients with the low-risk polyps are 5 to 10 years, and for high-risk are 3 years.

Aims We would like to investigate what is the time of follow-up interval in the patients (low- and high-risk) at present.

Methods We retrospectively study individuals who had undergone surveillance colonoscopy during 2011 through 2017 in a community hospital. Each time colonoscopic findings were divided to two groups: (1) low-risk polyps (2) high-risk polyps. No polyps or small (<10 mm) hyperplastic polyps detected were inclusive to low-risk polyps.

Results A total of 55 patients were collected. 40 patients (72.7%) were in low-risk polyps group and 15 (27.3%) were in high-risk polyps group according to their first colonoscopy result. In low-risk group, the average years of follow-up intervals are 3.68 years (SD 2.09), and 27 of 40 patients (67.5%) are less than 5 years (range 1–4 years). Positive fecal occult blood test (29.6%), bloody stool passage (22.2%) and colonic polyps’ history (25.5%) are the common reasons why these patients practiced next screening colonoscopy in advance. In high-risk group, the average years of follow-up intervals are 2.38 years (SD 1.45), and 10 of 15 patients (67.5%) are less than 3 years (range 1–2 years). Colonic polyps’ history (70%) is the most frequent reasons why the patients practiced next screening colonoscopy in advance. Another issue is for age older than 75 years old, 2 of 5 patients had high-risk polyps at first time colonoscopy, however, they all had low risk polyps at follow-up colonoscopy surveillance.

Conclusions This study reveals the discrepancy between practitioner recommendations and current guidelines for colonoscopy surveillance in the time of follow-up colonoscopy. It might be caused by frequent fecal occult blood test (biennial), bowel cleansing preparation, and continuing education for practitioners. The Ministry of Health and Welfare must conduct a broader assessment of screening schedule.

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