Michaud-Herbst A, Jouhet V, Ingrand P, Letard JC, Dupuychaffray JP, Barrioz T, Beauchant M. Evaluation of French guidelines on the indications of colonoscopy: results of a regional practice survey.
Clin Res Hepatol Gastroenterol 2011;
35:839-44. [PMID:
21917542 DOI:
10.1016/j.clinre.2011.07.016]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Accepted: 07/26/2011] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS
Compliance with guidelines on colonoscopic indications can improve colorectal cancer screening efficiency. We conducted a regional practice survey of gastroenterologists working in the public and private sectors in France, and compared the results with French national guidelines.
METHODS
Four consecutive yearly questionnaire-based practice surveys were conducted, and remedial measures were recommended on the basis of the results.
RESULTS
We analyzed 5128 colonoscopies carried out by 65 practitioners. Of these, 4266 (83.2%) conformed to contemporary guidelines, 391 (7.6%) did not conform, and 471 (9.2%) could not be classified, owing to a lack of information. Remedial measures led to a significant increase in the number of colonoscopies conforming to guidelines (p=0.037) and to a significant fall in the number of unclassified procedures (p=0.0018). The distribution of colonic lesions differed between procedures that did and did not conform to guidelines (2.4% versus 0.3% of colorectal cancers, 11.4% vs. 6.9% of advanced adenomas, and 17.5% vs. 14.6% of non-advanced adenomas; p<0.0001).
CONCLUSION
This longitudinal multicenter survey shows that national colonoscopy guidelines are largely respected in France and improve the detection of colonic neoplasia. Practices improved following implementation of remedial measures.
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