Too many colonoscopies?

There’s increasing evidence that clinicians recommend post-polypectomy colonoscopies more often than necessary.

A group of researchers led by Vikram Boolchand, MD, at the University of Arizona Health Sciences Center in Tucson, asked 1,000 internists and family practitioners when they would recommend repeated colonoscopy for a hypothetical 55-year-old man with no family history of colorectal cancer after a variety of results on colonoscopy, including two low-risk scenarios: one hyperplastic polyp and one or two 6-mm tubular adenomas.

Of the 568 responding clinicians, 61% said they would recommend a colonoscopy in five years or less for patients with a hyperplastic polyp, and fully 80% said they’d recommend repeat colonoscopy in three years or less for patients with two tubular adenomas.

These intervals contrast with those recommended by the U.S. Multisociety Task Force on Colorectal Cancer, which discourages surveillance for hyperplastic polyps and recommends five- to 10-year surveillance for one or two small tubular adenomas.

The authors note that clinicians may overrefer for surveillance for several reasons, including fear of liability claims and lack of awareness of current guidelines (Ann Intern Med. 2006;145:654-659).