Ow, T; Angelica, B; Burn, S; Chu, M; Lee, S; Lin, R; Tran, V; Iyngkaran, G; Bampton, P; Sukocheva, O; Tse, E; Rayner, C

Author(s)

Ow, T

Angelica, B

Burn, S

Chu, M

Lee, S

Lin, R

Tran, V

Iyngkaran, G

Bampton, P

Sukocheva, O

Tse, E

Rayner, C

Publication Date

2023-06-01

Abstract

BACKGROUND: The latest update to the Australian adenoma surveillance guideline in 2018 introduced a novel risk stratification system with updated surveillance recommendations. The resource implications of adopting this new system are unclear. METHODS: We studied data from 2443 patients undergoing colonoscopies, in which a clinically significant lesion was identified in their latest, or previous procedure(s) across five Australian hospitals. We excluded procedures with inflammatory bowel disease, new or prior history of colorectal cancer or resection, inadequate bowel preparation, and incomplete procedures. Old and new Australian surveillance intervals were calculated according to the number, size, and histological characteristics of lesions identified. We used these data to compare the rate of procedures according to each guideline. RESULTS: Based on the procedures for 766 patients, the new surveillance guidelines significantly increased the number of procedures allocated an interval of one year (RR 1.57, p = 0.009) and ten years (RR 3.83, p <0.00001), and reduced those allocated to half a year (RR 0.08, p = 0.00219), three years (RR 0.51, p <0.00001), and five years (RR 0.59, p <0.00001). Overall, this reduced the relative number of surveillance procedures by 21% over ten years (25.92 vs 32.78 procedures/100 patient-years), which increased to 22% after excluding patients 75 or older at the time of surveillance (19.9 vs 25.65 procedures/100 patient-years). CONCLUSION: The adoption of the latest Australian adenoma surveillance guidelines can reduce demand for surveillance colonoscopy by more than a fifth (21-22%) over ten years. This article is protected by copyright. All rights reserved.

Affiliation

Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.

Department of Gastroenterology, Royal Darwin Hospital, Casuarina, The Northern Territory, Australia.

Department of Gastroenterology and Hepatology, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.

Department of Gastroenterology and Hepatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.

Citation

Intern Med J . 2024 Feb;54(2):250-257. doi: 10.1111/imj.16149. Epub 2023 Jun 21.

OrcId

0000-0002-5405-7681

0000-0003-0466-4915

Pubmed ID

https://pubmed.ncbi.nlm.nih.gov/37287100/?otool=iaurydwlib

Link

https://hdl.handle.net/10137/12476

Title

Comparing the resource implications of old and new colorectal adenoma surveillance guidelines in Australia.

Type of document

Journal Article

Entity Type

Publication

Author(s)	Ow, T Angelica, B Burn, S Chu, M Lee, S Lin, R Tran, V Iyngkaran, G Bampton, P Sukocheva, O Tse, E Rayner, C
Publication Date	2023-06-01
Abstract	BACKGROUND: The latest update to the Australian adenoma surveillance guideline in 2018 introduced a novel risk stratification system with updated surveillance recommendations. The resource implications of adopting this new system are unclear. METHODS: We studied data from 2443 patients undergoing colonoscopies, in which a clinically significant lesion was identified in their latest, or previous procedure(s) across five Australian hospitals. We excluded procedures with inflammatory bowel disease, new or prior history of colorectal cancer or resection, inadequate bowel preparation, and incomplete procedures. Old and new Australian surveillance intervals were calculated according to the number, size, and histological characteristics of lesions identified. We used these data to compare the rate of procedures according to each guideline. RESULTS: Based on the procedures for 766 patients, the new surveillance guidelines significantly increased the number of procedures allocated an interval of one year (RR 1.57, p = 0.009) and ten years (RR 3.83, p <0.00001), and reduced those allocated to half a year (RR 0.08, p = 0.00219), three years (RR 0.51, p <0.00001), and five years (RR 0.59, p <0.00001). Overall, this reduced the relative number of surveillance procedures by 21% over ten years (25.92 vs 32.78 procedures/100 patient-years), which increased to 22% after excluding patients 75 or older at the time of surveillance (19.9 vs 25.65 procedures/100 patient-years). CONCLUSION: The adoption of the latest Australian adenoma surveillance guidelines can reduce demand for surveillance colonoscopy by more than a fifth (21-22%) over ten years. This article is protected by copyright. All rights reserved.
Affiliation	Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia. Department of Gastroenterology, Royal Darwin Hospital, Casuarina, The Northern Territory, Australia. Department of Gastroenterology and Hepatology, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia. Department of Gastroenterology and Hepatology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
Citation	Intern Med J . 2024 Feb;54(2):250-257. doi: 10.1111/imj.16149. Epub 2023 Jun 21.
OrcId	0000-0002-5405-7681 0000-0003-0466-4915
Pubmed ID	https://pubmed.ncbi.nlm.nih.gov/37287100/?otool=iaurydwlib
Link	https://hdl.handle.net/10137/12476
Title	Comparing the resource implications of old and new colorectal adenoma surveillance guidelines in Australia.
Type of document	Journal Article
Entity Type	Publication

Comparing the resource implications of old and new colorectal adenoma surveillance guidelines in Australia.

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