Follow up of patients with colorectal polyps: are the BSG guidelines being adhered to?

Colorectal Dis. 2007 Mar;9(3):203-6. doi: 10.1111/j.1463-1318.2006.01180.x.

Abstract

Objective: The publication of the BSG guidelines in 2002 provided a framework for the follow up of patients with colorectal polyps. The aim of the present study was to determine whether they had, or were being correctly adhered to in a moderately sized District General Hospital.

Method: A total of 598 patients were on the waiting list for colonoscopy at Airedale General Hospital (AGH) in February 2005. Of these, 203 were being followed up as a result of the previous finding of a polyp.

Results: Only 14.8% of patients had been or were being followed up according to the BSG guidelines. The majority of the 85.2% of patients who did not comply with follow up did so as a result of over investigation. Seventy-eight per cent of the low-risk group and 55% of the intermediate-risk group had been colonoscoped, or were waiting to have colonoscopy, too soon or too frequently according to the BSG guidelines. Twenty-four patients with hyperplastic polyps were being followed up incorrectly, as were 17 patients discovered to have a polyp pathology on flexible sigmoidoscopy. It was established that 131 extra colonoscopies had been, or were planned to be performed unnecessarily.

Conclusion: These data have major implications with regard to patient safety, service provision and cost to the NHS.

MeSH terms

  • Colonic Polyps / diagnosis
  • Colonic Polyps / pathology
  • Colonic Polyps / surgery*
  • Colonoscopy / standards*
  • Colonoscopy / statistics & numerical data
  • Follow-Up Studies
  • Guideline Adherence
  • Hospitals, District
  • Humans
  • Patient Compliance
  • Practice Guidelines as Topic
  • Retrospective Studies
  • United Kingdom
  • Unnecessary Procedures