Effect of Applying the 2020 ESGE Post-Polypectomy Surveillance Guidelines on the Surveillance Recommendations: Study on A Population-Based CRC Screening Program

Aims Post-polypectomy surveillance is one of the most frequent indications for a colonoscopy, representing a heavy burden for endoscopy units. Our aim was to compare the surveillance intervals recommended by the recent ESGE 2020 guidelines with the ones recommended by the ESGE 2013 and the USMUSTF 2019 guidelines in our CRC screening population.

Methods Retrospective review of our CRC screening database, integrated in the population- based CRC screening program of the Valencian region in Spain. Only index complete screening colonoscopies on individuals 50 to 75 years-old, with an at least adequate bowel preparation (Boston 6) and performed from April 2017 to May 2020 were included. We compared the surveillance recommendations of each guideline, identified discrepancies and evaluated the influence of villous pattern and number of detected adenomas on these discrepancies.

Results 1284 colonoscopies were included. [Tab. 1] summarizes the surveillance recommendations of the three guidelines. Almost a third of the 3 yrs. colonoscopies proposed by ESGE 2013 and by USMUSTF 2019 changed to 10 yrs. following ESGE 2020.

ESGE 2020	ESGE 2013		USMUSTF 2019
	10 yrs	3 yrs	10 yrs[*]	3 yrs[**]
10 yrs	796 (100 %)	140 (30.3 %)	795 (100 %)	141 (30.4 %)
3 yrs	0	322 (69.7 %)	0	322 (69.4 %)

^* Includes 10yrs, 7-10 yrs and 5-10 yrs;

^** Includes 3-5 yrs and 3 yrs

The differences between both ESGE guidelines were attributable to the removal of villous component as a high-risk criterium (36, 25.7 %), categorizing 3-4 adenomas as low risk (71, 50.7 %) or both (26, 18.6 %). Similarly, the differences between ESGE 2020 and USMUSTF 2019 was 40 (23.9 %) for villous component, 81 (48.5 %) for number of adenomas and 43 (25.7 %) for both.

Conclusions Applying the new ESGE 2020 guidelines reduces in almost a third the number of colonoscopies in the third-year control. Disappearance of the villous component and 3-4 adenomas as high-risk factors are the main reason for this change.

Citation: Bustamante-Balén M, García-Campos M, Alonso N et al. OP47 EFFECT OF APPLYING THE 2020 ESGE POST-POLYPECTOMY SURVEILLANCE GUIDELINES ON THE SURVEILLANCE RECOMMENDATIONS: STUDY ON A POPULATION-BASED CRC SCREENING PROGRAM. Endoscopy 2021; 53: S21.

Publication History

Article published online:
19 March 2021