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Comment
. 2025 Jan 29:13:a24094916.
doi: 10.1055/a-2409-4916. eCollection 2025.

Patient adherence to surveillance colonoscopy after endoscopic resection of colorectal polyps and factors associated with loss to follow-up

Aimen Farooq  1 , BahaAldeen Bani Fawwaz  1 , Arooj Mian  2 , Gurdeep Singh  2 , Yiyang Zhang  3 , Peter Gerges  2 , Kambiz Kadkhodayan  4 , Deepanshu Jain  4 , Natalie Cosgrove  4 , Mustafa A Arain  4 , Muhammad Khalid Hasan  5 , Dennis Yang  4
Affiliations
Comment

Patient adherence to surveillance colonoscopy after endoscopic resection of colorectal polyps and factors associated with loss to follow-up

Aimen Farooq et al. Endosc Int Open. .

Abstract

Background and study aims: Post-polypectomy surveillance colonoscopy (SC) plays an integral role in efforts to reduce colorectal cancer risk, but its effectiveness is invariably dependent on patient compliance. This study aimed to evaluate patient adherence to SC after endoscopic resection (ER) of polyps ≥ 20 mm and identify potential barriers associated with loss to follow-up.

Patients and methods: This was a single-center retrospective study evaluating adherence to SC after ER of polyps ≥ 20 mm between April 2018 to December 2021. Adherence to SC was defined as the proportion of patients who underwent follow-up colonoscopy. Multivariate logistic regression was performed to identify factors associated with loss to follow-up.

Results: A total of 959 patients (mean age 67 years; 47.9% women) underwent endoscopic resection of colorectal polyps ≥ 20 mm (mean size 33.2 ± 13.7 mm). Nearly half of the patients (n = 478; 49.8%) were lost to follow-up. On multivariate analysis, factors associated with a higher likelihood of SC non-adherence were: lack of a primary care physician (odds ratio [OR] 1.7;95% confidence interval [CI] 1.3- 2.3; P < 0.05), American Society of Anesthesiologists grade 3 or 4 (OR 1.4; 95% CI 1.1-1.9; P < 0.05), residence > 60 miles from the endoscopy suite (OR 1.6; 95% CI 1.2-2.3; P = 0.02), being referred by a physician outside of our healthcare system (OR 1.4; 95% CI 1.1-1.8; P = 0.01), and lack of written follow-up recommendations on the colonoscopy report (OR 3.6; 95% CI 1.4-10.2; P = 0.01).

Conclusions: Nearly half of patients undergoing ER of colorectal polyps ≥ 20 mm are lost to follow-up. We identified several patient- and healthcare-related factors as barriers to SC adherence. Strategies to address these issues and targeting of high-risk populations are urgently needed to enhance SC programs.

Keywords: Colorectal cancer; Endoscopic resection (polypectomy, ESD, EMRc, ...); Endoscopy Lower GI Tract; Polyps / adenomas / ....

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Conflict of interest statement

Conflict of Interest D. Yang is a consultant for Olympus, Fujifilm, Apollo Endosurgery, Medtronic, and Microtech. D. Yang receives research support from Microtech and 3D-Matrix. M.K. Hasan is a consultant for Boston Scientific, Microtech, and Olympus. M. Arain is a consultant for Boston Scientific and Olympus. N. Cosgrove is a consultant for Boston Scientific and Olympus. All other authors have nothing to disclose.

Figures

Fig. 1
Fig. 1
Patient flow chart.
See this image and copyright information in PMC

Comment on

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