Abstract
BACKGROUND: In 2020, the US Multi-Society Task Force (USMSTF) on Colorectal Cancer revised its recommended interval for surveillance of 1 to 2 subcentimeter tubular adenomas from 5 to 10 years to 7 to 10 years. This study assessed the impact of retroactively applying these guidelines on endoscopy center capacity.
METHODS: Colonoscopy reports were reviewed for patients with an upcoming colonoscopy reminder at the Veterans Affairs Pittsburgh Healthcare System (VAPHS). Patients with incomplete records, high-risk indications, or inadequate bowel preparation were excluded. Previous surveillance recommendations were compared with the 2020 USMSTF guideline to determine whether colonoscopy intervals could be extended.
RESULTS: Of 583 patients, 331 (56.7%) had adequate data to determine extendibility. Using the 2020 USMSTF guidelines, colonoscopy interval could be extended by ≥ 1 year for 64 patients (11%) for a total of 153 years extended. For 36 patients, the ability to extend the colonoscopy interval was directly attributable to the updated 2020 USMSTF guideline.
CONCLUSIONS: Retroactive application of USMSTF surveillance guidelines could modestly increase endoscopic capacity, but overall impact may be limited by fragmentation of care.