P0390 - The Effect of the USMSTF 2020 Guidelines on Colonoscopy Surveillance Interval in a Community GI Practice

Jayati Anand, BS¹, Yuvaraj Singh, MD², George Abraham, MD, MPH^3
1Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA; ²University of Massachusetts, Worcester, MA; ³Saint Vincent Hospital, Worcester, MA

Introduction: About 25% of colonoscopies performed in the United States are for surveillance, and data suggests there may be over-utilization of surveillance colonoscopies. The USMSTF 2020 guideline, although more complex than the previous version, offers significant benefits. A notable change is the lengthening of surveillance intervals for 1–2 adenomas (< 10 mm) to 7–10 years instead of 5 years, and for 3–4 adenomas (< 10 mm) to 3–5 years instead of 3 years. We reviewed whether gastroenterologists in the community setting have adopted the new guidelines by reflecting changes in their recommended colonoscopy surveillance intervals.

Methods: This retrospective cross-sectional study reviewed 1700 reports of screening and surveillance colonoscopies at a community hospital from April 2018 to April 2023. Data was split before and after the 2020 guidelines. Demographics and polyp characteristics were recorded, including frequency, size, histology, and suggested follow-up interval. Unsatisfactory bowel preparation, high-risk indications (IBD, family history of GI malignancies), incomplete colonoscopy, non-adenomatous histology, >4 polyps, and no polyp findings were excluded. Data was sub-stratified to < 3 polyps and 3-4 polyps. A One-way Analysis of Variance (ANOVA) was used to evaluate the difference between the means of recommended duration of surveillance colonoscopy before and after the guidelines.

Results: A total of 706 reports met the inclusion criteria. The median age was 60, and 44% were female. Amongst 440 colonoscopies with < 3 adenomas, the mean follow-up before (n=107) and after the guidelines (n=173) was 4.88 years and 5.03 years, respectively. Amongst 154 colonoscopies with 3-4 adenomas, the mean follow-up before (n=47) and after the guidelines (n=107) was 3.21 years and 3.24 years, respectively. ANOVA revealed no statistically significant difference in the mean duration of follow-up colonoscopy in both groups.

Discussion: Our study reveals that in the community setting, most gastroenterologists have not adjusted their colonoscopy follow-up recommendations to align with the new USMSTF 2020 guidelines. This conservative approach by community gastroenterologists could potentially lead to patients undergoing more colonoscopies than necessary. We consider this significant, suggesting a potential need for education of and engagement with community gastroenterologists to align community practice with the changes in the guidelines.



Disclosures:


Jayati Anand, BS¹, Yuvaraj Singh, MD², George Abraham, MD, MPH³. P0390 - The Effect of the USMSTF 2020 Guidelines on Colonoscopy Surveillance Interval in a Community GI Practice, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.