Endoscopy 2019; 51(07): 673-683
DOI: 10.1055/a-0865-2082
© Georg Thieme Verlag KG Stuttgart · New York

Adherence to post-polypectomy surveillance guidelines: a systematic review and meta-analysis

Roupen Djinbachian
1   University of Montreal, Faculty of Medicine, and Montreal University Hospital Research Center (CRCHUM), Montreal, Canada
Anne-Julie Dubé
1   University of Montreal, Faculty of Medicine, and Montreal University Hospital Research Center (CRCHUM), Montreal, Canada
Madeleine Durand
2   Division of Internal Medicine, Montreal University Hospital Center (CHUM) and Montreal University Hospital Research Center (CRCHUM), Montreal, Canada
Louopou Rosalie Camara
1   University of Montreal, Faculty of Medicine, and Montreal University Hospital Research Center (CRCHUM), Montreal, Canada
Benoit Panzini
3   Division of Gastroenterology, Montreal University Hospital Center (CHUM) and Montreal University Hospital Research Center (CRCHUM), Montreal, Canada
Simon Bouchard
3   Division of Gastroenterology, Montreal University Hospital Center (CHUM) and Montreal University Hospital Research Center (CRCHUM), Montreal, Canada
Daniel von Renteln
3   Division of Gastroenterology, Montreal University Hospital Center (CHUM) and Montreal University Hospital Research Center (CRCHUM), Montreal, Canada
› Author Affiliations
Further Information

Publication History

submitted 18 October 2018

accepted after revision 04 February 2019

Publication Date:
25 March 2019 (online)


Background Colorectal cancer (CRC) is a major worldwide cause of cancer-related mortality. Colonoscopy programs based on guideline-recommended surveillance intervals have been put in place to reduce the morbidity and mortality associated with CRC. We were interested to evaluate clinical practice adherence to guideline-recommended surveillance intervals, the potential extent of early repeat colonoscopies, and causes of nonadherence to guideline recommendations.

Methods We performed a literature search for articles reporting on guideline adherence for surveillance colonoscopies. Exclusion criteria included inflammatory bowel disease and hereditary CRC syndrome cohorts. Primary outcome was correct interval assignment in patients undergoing surveillance colonoscopy. Groups were assessed for adherence according to their respective guideline recommendations (North American or European).

Results 16 studies were included in the analysis. The mean colonoscopy surveillance interval adherence rate was 48.8 % (95 % confidence interval [CI] 37.3 – 60.4). For North American guidelines, surveillance interval assignments were adherent to guideline recommendations in 44.7 % (95 %CI 24.2 – 66.3) of patients after detection of low risk lesions and in 54.6 % (95 %CI 41.4 – 67.4) after detection of high risk lesions. For European guidelines, surveillance interval assignments were adherent to recommendations in 24.4 % (95 %CI 1.1 – 63.4) of patients after detection of low risk lesions and in 73.6 % (95 %CI 35.5 – 98.8) after detection of high risk lesions.

Conclusions The worldwide adherence to surveillance colonoscopy guidelines was low, with more than 50 % of patients undergoing repeat colonoscopies either too early or too late. Early repeat colonoscopies occurred with the highest frequency for patients in whom only hyperplastic polyps or low risk adenomas were found.

Supplementary material

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