Compliance with follow-up guidelines after high-risk colorectal polyp removal: a population-based study

Background and Aims: After high-risk colorectal adenoma removal, colorectal cancer risk remains higher than that in the general population. Depending on polyp characteristics, a 3-month or 3-year follow-up colonoscopy is recommended, and clear follow-up instructions must be given to the patient. Our primary aim was to evaluate compliance with French follow-up recommendations. Second, we evaluated the impact of how the information was given and if patients actually underwent their control colonoscopy according to the instructions given. Methods: We collected data from the Burgundy polyp population-based registry and medical records from the endoscopy centers of the area. Between June 30, 2014 and July 1, 2015, 405 patients were included in this study. Results: Written follow-up instructions were provided to 345 patients (85.2%), and 184 of them (53.3%) complied with guidelines. For 29.9% the interval to follow-up colonoscopy was longer than recommended, and for 6.4% the interval was shorter. Among the 303 patients who had clear follow-up instructions, 42.2% had their control colo-noscopy and 83.6% respected the stipulated interval. Follow-up instructions were found in the colonoscopy report in at least 49% of cases. Conclusions: Compliance with follow-up guidelines was poor: Inappropriate intervals were often longer than recommended. Patients with written follow-up instructions and those who underwent follow-up colonoscopy mostly followed these instructions. Ensuring compliance with guidelines and giving written instructions to pa-tients should be primary goals to achieve effective follow-up. Gastroenterologist training should be improved in this way.

Automated summary

This study aimed to evaluate compliance with French follow-up recommendations after high-risk colorectal adenoma removal and assess the impact of how information was given and if patients actually underwent their control colonoscopy according to the instructions. The results showed poor compliance with follow-up guidelines, with inappropriate intervals often being longer than recommended.