Endoscopy 2018; 50(02): 119-127
DOI: 10.1055/s-0043-119637
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Surveillance colonoscopy in Austria: Are we following the guidelines?

Irina Gessl
1  Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Austria
2  Quality Assurance Working Group, Austrian Society of Gastroenterology and Hepatology (OEGGH), Vienna, Austria
,
Elisabeth Waldmann
1  Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Austria
2  Quality Assurance Working Group, Austrian Society of Gastroenterology and Hepatology (OEGGH), Vienna, Austria
,
Martha Britto-Arias
1  Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Austria
2  Quality Assurance Working Group, Austrian Society of Gastroenterology and Hepatology (OEGGH), Vienna, Austria
,
Daniela Penz
2  Quality Assurance Working Group, Austrian Society of Gastroenterology and Hepatology (OEGGH), Vienna, Austria
,
Eleonore Pablik
3  Department for Medical Statistics, Division of Clinical Biometrics, Medical University of Vienna, Austria
,
Michael Trauner
1  Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Austria
2  Quality Assurance Working Group, Austrian Society of Gastroenterology and Hepatology (OEGGH), Vienna, Austria
,
Monika Ferlitsch
1  Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Austria
2  Quality Assurance Working Group, Austrian Society of Gastroenterology and Hepatology (OEGGH), Vienna, Austria
› Author Affiliations
Further Information

Publication History

submitted 13 March 2017

accepted after revision 04 August 2017

Publication Date:
24 October 2017 (eFirst)

Abstract

Background and study aim The European guidelines for quality assurance in colorectal cancer screening and diagnosis contain postpolypectomy surveillance recommendations. They recommend follow-up intervals depending on the findings at index colonoscopy, and divide patients into a low-, intermediate- or high-risk group. The aim of this study was to assess the adherence of Austrian endoscopists to the European guidelines and to determine whether sending a reminder letter resulted in better adherence.

Methods A single reminder letter containing the guidelines was sent to all endoscopists who participated in the Certificate of Quality for Screening Colonoscopy program in Austria. Adherence was assessed before and after the letter had been sent. Factors associated with adherence were investigated.

Results We found poor baseline adherence to the guidelines. After the reminder letter, the adherence slightly improved in the low-risk group, but did not change in the intermediate-risk or high-risk groups. An adenoma detection rate of at least 20 % was associated with higher adherence rates. Generally, internists and hospitals showed better adherence compared with surgeons and private practices, respectively, both before and after the reminder letter.

Conclusion A single reminder letter was not enough to improve the poor adherence to the European postpolypectomy surveillance guidelines. Thus, future studies are required to identify and eliminate all factors responsible for nonadherence to postpolypectomy guidelines in order to reach the goal of a safe, effective, and cost-effective colorectal cancer prevention tool in the near future.