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  • Title: Colorectal screening after polypectomy: a national survey study of primary care physicians.
    Author: Boolchand V, Olds G, Singh J, Singh P, Chak A, Cooper GS.
    Journal: Ann Intern Med; 2006 Nov 07; 145(9):654-9. PubMed ID: 17088578.
    Abstract:
    BACKGROUND: Recommendations by primary care physicians for colorectal screening after polypectomy will influence rates of colonoscopy in open-access systems that do not require consultation by a gastroenterologist before colonoscopy. OBJECTIVE: To determine the surveillance recommendations of primary care physicians after polypectomy and compare them with recommendations from the U.S. Multisociety Task Force on Colorectal Cancer. DESIGN: Cross-sectional study of physicians. SETTING: United States. PARTICIPANTS: A random sample of 500 physicians from the American College of Physicians and 500 physicians from the American Academy of Family Physicians, obtained by using a mail survey. MEASUREMENTS: Physicians were asked when they would recommend repeated colonoscopy for a hypothetical 55-year-old man with no family history of colorectal cancer after the following 6 results on colonoscopy: hyperplastic polyp, one 6-mm tubular adenoma, two 6-mm tubular adenomas, one 12-mm tubulovillous adenoma, one 12-mm tubular adenoma with focal high-grade dysplasia, and no polyp but a previous tubular adenoma. RESULTS: The overall response rate was 57% (568 physicians). Of the respondents, 48% were internists and 52% were family practitioners. Sixty-one percent of respondents would survey a hyperplastic polyp in 5 years or less, 71% would survey a single tubular adenoma in 3 years or less, and 80% would survey 2 tubular adenomas in 3 years or less. LIMITATIONS: The results are based on physicians' self-reported practices from clinical vignettes and may not match actual practice. CONCLUSION: Primary care physicians recommend postpolypectomy colonoscopic surveillance more frequently than is recommended by practice guidelines, especially if the colonoscopy showed a hyperplastic polyp or a single small adenoma.
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