Proper Frequency of Screening Colonoscopy in Our Patients: American or British?
How often do we recommend repeat colonoscopy in our patients at risk of colon polyps or cancer? Do we just leave this to gastroenterologists and primary physicians, or do we make stronger recommendations to pour patents and our medical colleagues (e.g. at tumor boards)?
A publication by M. Martinez and coauthors (Ann Intern Med 2012; 157: 856) compared the impact of using British rather than American guidelines. In England, patients with >5 small (<1 cm) adenomas or 3 or more adenomas at least one >1cm are considered high risk, and repeat colonoscopy is recommended in 1 year. When following the U.K. guidelines, there was an increase of 19% in finding and removing new polyps.
Since medical oncologists are frequently sennding our patients for colonoscopy following colon cancer care, It is important for us to be aware of this issue. More polyp removals means better prevention. With this recent publication in mind, I am now referring such patients with high risk colonoscopy results for earlier repeat procedure.