Surveillance colonoscopies frequently booked earlier than the National Health and Medical Research Council guidelines: findings of a single centre audit

Background

To assess the adherence rate of surveillance colonoscopy booking intervals to recommended National Health and Medical Research Council guidelines at The Queen Elizabeth Hospital, Adelaide, Australia.

Methods

Patients on The Queen Elizabeth Hospital colorectal unit surveillance colonoscopy waiting list were included in this audit. Patient demographics, colonoscopy findings, follow‐up plans and pathology results were analysed. Patients were categorized as normal/non‐neoplastic finding, low‐risk adenomas, high‐risk adenomas, personal history of colorectal cancer (CRC) and family history of CRC. Booked colonoscopy within 2 months of guideline recommended interval was considered correct.

Results

A total of 467 patients were included (59.1% male; mean age 60 years). Two hundred and fifty‐one (53.7%) patients had an incorrect surveillance colonoscopy booking. Twenty‐seven patients with a normal/non‐neoplastic previous colonoscopy not requiring surveillance colonoscopy were incorrectly booked for a colonoscopy. For the 222 patients booked incorrectly and requiring surveillance colonoscopy, 88.7% were early and 11.3% were late. The proportions of incorrect bookings were highest in the low‐risk finding (66.1%) and history of CRC (67.6%) groups. For the 186 patients requiring a 3‐year surveillance interval, 38.7% were booked incorrectly. For the 197 patients requiring a 5‐year surveillance interval, 63.5% were booked incorrectly, of which 99.2% were early. More 5‐year surveillance interval patients were booked at 3 years (n = 79), than at the correct interval of 5 years (n = 72).

Conclusion

Adherence to the National Health and Medical Research Council guidelines for surveillance colonoscopy is poor. The majority of deviations represent early follow‐up, which is most common among patients with low‐risk findings or history of CRC. There is a tendency towards 3‐year surveillance among low‐risk patients.

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