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- Title
Rising Use of Surveillance Colonoscopy and Potential Impacts.
- Authors
Adams, Megan A.; Rubenstein, Joel H.; Holleman, Rob; Lipson, Rachel; Klamerus, Mandi L.; Zoulek, Shannon; Saini, Sameer D.
- Abstract
OBJECTIVES: To quantify temporal changes in colonoscopy indication and assess appropriateness of surveillance use in older adults. STUDY DESIGN: Retrospective longitudinal study of national Veterans Health Administration (VHA) data of all patients who underwent outpatient colonoscopy in 2005-2014. METHODS: After validating an electronic algorithm for classifying colonoscopy indication in VHA, we examined trends in colonoscopy indication over time and across patient characteristics. RESULTS: The proportion of colonoscopies performed for postpolypectomy surveillance increased significantly during the study period, particularly among older patients with limited life expectancy, raising concern for possible overuse. CONCLUSIONS: Guidelines should make clear recommendations about when and how to discontinue postpolypectomy surveillance colonoscopy. Doing so would potentially reduce harms due to complications from low-value procedures and in turn moderate demand and thereby enhance overall procedural access for patients more likely to benefit.
- Publication
American Journal of Managed Care, 2022, Vol 28, Issue 5, p229
- ISSN
1088-0224
- Publication type
Academic Journal
- DOI
10.37765/ajmc.2022.89144