Evaluating the impact of 2020 post-polypectomy surveillance guidelines in the Northern Ireland bowel cancer screening programme

Abstract

Contributors the report was devised and drafted by MBL. GI and HGC performed data analysis. WD and tAO contributed to data interpretation. All authors approved the final version. Funding HGC is funded by a Cancer research UK Career establishment Award (reference:C37703/ A25820). *These 609 high-risk cases under 2020 guidance (see ref. 1 for definitions) comprise: 371 cases with advanced polyp (AP) plus 1-3 other premalignant polyps (PMP) but total <5; 114 cases with ≥5 PMPs but no APs; 101 cases with ≥5 PMPs and at least 1 AP; 23 cases with an isolated large (≥20 mm), large non-pedunculated colorectal polyp and no other PMPs.

Impact of the European Society of Gastrointestinal Endoscopy 2020 guidelines on the number of scheduled post-polypectomy surveillance colonoscopies

“…The influence of changing criteria for stratifying risk has been previously shown in a recent study performed in the Northern Ireland Bowel Cancer Screening program evaluating the potential impact of the new British Society of Gastroenterology (BSG) 2020 guideline on surveillance regimens, compared to the previous 2010 guideline. The authors showed a 50.3 % reduction in the number of individuals scheduled for surveillance 19 , higher than that detected in the present study. However, in the Irish study, the reduction is essentially attributable to the disappearance of the “intermediate-risk” group in the new BSG 2020 guideline 4 , a group not existing neither in the ESGE 2013 nor in the USMSTF 2020 guidelines.…”

“…regimens, compared to the previous 2010 guideline. The authors showed a 50.3% reduction in the number of individuals scheduled for surveillance [19], higher than that detected in the present study. However, in the Irish study, the reduction is essentially attributable to the disappearance of the "intermediaterisk" group in the new BSG 2020 guideline [4], a group not existing neither in the ESGE 2013 nor in the USMSTF 2020 guidelines.…”

“…We also wanted to evaluate the influence of SSLs on changes in follow-up intervals. In the Irish study 19 , 2.5 % of patients moved to a “high-risk” group when applying the BSG 2020 guidelines because of the presence of serrated lesions (SSLs or HP), lesions not considered in the previous BSG guideline. In our study, when following the ESGE 2020 guidelines, no patient with SSLs moved to a shorter surveillance interval, because ESGE 2013 and USMSTF 2002 considered serrated lesions already.…”