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Many Patients With Polyps Delay Follow-up Colonoscopy: Study

MONDAY, Nov. 26, 2018 -- Many people found to have colon polyps (adenomas) that can lead to cancer don't have follow-up colonoscopies at recommended times, a new study finds.

Patients who have certain types of adenomas, or large or numerous ones, are at increased risk for colorectal cancer, the study authors reported in the Nov. 20 issue of the journal Cancer Epidemiology, Biomarkers & Prevention.

"When a patient is found to have some of these higher-risk findings, guidelines recommend that they come back for another colonoscopy in three years. This is called surveillance colonoscopy, and it improves our chances of preventing colorectal cancer or detecting it at an early stage," study author Jessica Chubak said in a journal news release.

Chubak is a senior scientific investigator at Kaiser Permanente Washington Health Research Institute.

Her team analyzed data from more than 6,900 U.S. patients, aged 50 to 89, with high-risk adenomas. The patients had their initial colonoscopies done at one of three Kaiser Permanente systems, or at the Parkland Health & Hospital System, which treats patients regardless of their insurance status or ability to pay.

Between 47 percent and 59.5 percent of the Kaiser Permanente patients had a follow-up colonoscopy within 3 1/2 years, compared with 18.3 percent of Parkland patients.

The significantly lower rate at Parkland was most likely due to differences in patient populations and resources, according to Chubak.

The study found that patients with more adenomas or with higher-risk adenomas were more likely to get the follow-up colonoscopy at the recommended time.

Age was another factor. Patients between the ages of 60 and 74 were more likely than those between the ages of 50 and 54 to get timely colonoscopies, while those in their 80s were less likely to do so.

"We encourage patients and health care providers to talk about how and when to test for colorectal cancer, and we encourage health care systems to find ways to support patients and providers in following the guidelines," she said. "In the future, it will be important to understand what types of reminders work best for different patient populations and in different health care settings."

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Posted: November 2018

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