Comparing the resource implications of old and new colorectal adenoma surveillance guidelines in Australia
Background The latest update to the Australian adenoma surveillance guideline in 2018 introduced a novel risk stratification system with updated surveillance recommendations. The resource implications of adopting this new system are unclear. Aims To quanitfy the resource demands of adopting new over...
Gespeichert in:
| Veröffentlicht in: | Internal medicine journal 2024-02, Vol.54 (2), p.250-257 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 257 |
|---|---|
| container_issue | 2 |
| container_start_page | 250 |
| container_title | Internal medicine journal |
| container_volume | 54 |
| creator | Ow, Tsai‐Wing Angelica, Bianca Burn, Sophie Chu, Matthew Lee, Shawn Z. Lin, Richard Tran, Vy Iyngkaran, Guru Bampton, Peter Sukocheva, Olga Tse, Edmund Rayner, Chris K. |
| description | Background
The latest update to the Australian adenoma surveillance guideline in 2018 introduced a novel risk stratification system with updated surveillance recommendations. The resource implications of adopting this new system are unclear.
Aims
To quanitfy the resource demands of adopting new over old adenoma surveillance guidelines.
Methods
We studied data from 2443 patients undergoing colonoscopies, in which a clinically significant lesion was identified in their latest, or previous procedure(s) across five Australian hospitals. We excluded procedures with inflammatory bowel disease, new or prior history of colorectal cancer or resection, inadequate bowel preparation and incomplete procedures. Old and new Australian surveillance intervals were calculated according to the number, size and histological characteristics of lesions identified. We used these data to compare the rate of procedures according to each guideline.
Results
Based on the procedures for 766 patients, the new surveillance guidelines significantly increased the number of procedures allocated an interval of 1 year (relative risk (RR): 1.57, P = 0.009) and 10 years (RR: 3.83, P |
| doi_str_mv | 10.1111/imj.16149 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2823990263</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2925717327</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3139-dde457d92aea12adbe3fcf9967128ddbd8ddf1654d5d05663bfe067c49609d383</originalsourceid><addsrcrecordid>eNp1kbtOBDEMRSME4l3wAygSDRQDec3MpkQrngLRQB1lEw9klUmWZIYVf09ggQIJF7aL4yvbF6EDSk5piTPXz09pQ4VcQ9tUiLqqpRTrX72oiCR8C-3kPCeEtlyKTbTFWzZpKSHbaD6N_UInF57x8AI4QY5jMoBdv_DO6MHFkHHscPQW62BxgCU20ccEZtAeawsh9hrnMb2B816HMvs8OgveBcjYBXw-5iFp7_Qe2ui0z7D_XXfR0-XF4_S6unu4upme31WGUy4ra0HUrZVMg6ZM2xnwznRSNi1lE2tntqSONrWwtSV10_BZB6RpjZANkZZP-C46XukuUnwdIQ-qd9nA53IQx6zYhHEpCWt4QY_-oPNyfijbKSZZ3ZZ_sbZQJyvKpJhzgk4tkut1eleUqE8DVDFAfRlQ2MNvxXHWg_0lfz5egLMVsHQe3v9XUjf3tyvJD_wWkMg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2925717327</pqid></control><display><type>article</type><title>Comparing the resource implications of old and new colorectal adenoma surveillance guidelines in Australia</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Ow, Tsai‐Wing ; Angelica, Bianca ; Burn, Sophie ; Chu, Matthew ; Lee, Shawn Z. ; Lin, Richard ; Tran, Vy ; Iyngkaran, Guru ; Bampton, Peter ; Sukocheva, Olga ; Tse, Edmund ; Rayner, Chris K.</creator><creatorcontrib>Ow, Tsai‐Wing ; Angelica, Bianca ; Burn, Sophie ; Chu, Matthew ; Lee, Shawn Z. ; Lin, Richard ; Tran, Vy ; Iyngkaran, Guru ; Bampton, Peter ; Sukocheva, Olga ; Tse, Edmund ; Rayner, Chris K.</creatorcontrib><description>Background
The latest update to the Australian adenoma surveillance guideline in 2018 introduced a novel risk stratification system with updated surveillance recommendations. The resource implications of adopting this new system are unclear.
Aims
To quanitfy the resource demands of adopting new over old adenoma surveillance guidelines.
Methods
We studied data from 2443 patients undergoing colonoscopies, in which a clinically significant lesion was identified in their latest, or previous procedure(s) across five Australian hospitals. We excluded procedures with inflammatory bowel disease, new or prior history of colorectal cancer or resection, inadequate bowel preparation and incomplete procedures. Old and new Australian surveillance intervals were calculated according to the number, size and histological characteristics of lesions identified. We used these data to compare the rate of procedures according to each guideline.
Results
Based on the procedures for 766 patients, the new surveillance guidelines significantly increased the number of procedures allocated an interval of 1 year (relative risk (RR): 1.57, P = 0.009) and 10 years (RR: 3.83, P < 0.00001) and reduced those allocated to half a year (RR: 0.08, P = 0.00219), 3 years (RR: 0.51, P < 0.00001) and 5 years (RR: 0.59, P < 0.00001). Overall, this reduced the relative number of surveillance procedures by 21% over 10 years (25.92 vs 32.78 procedures/100 patient‐years), which increased to 22% after excluding patients 75 or older at the time of surveillance (19.9 vs 25.65 procedures/100 patient‐years).
Conclusion
The adoption of the latest Australian adenoma surveillance guidelines can reduce demand for surveillance colonoscopy by more than a fifth (21–22%) over 10 years.</description><identifier>ISSN: 1444-0903</identifier><identifier>EISSN: 1445-5994</identifier><identifier>DOI: 10.1111/imj.16149</identifier><identifier>PMID: 37287100</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>Adenoma ; bowel cancer prevention ; colonoscopy ; Colorectal cancer ; Colorectal carcinoma ; economic modelling ; health resources ; Inflammatory bowel diseases ; Intestine ; Patients ; polyp surveillance ; Surveillance ; surveillance guidelines ; Tumors</subject><ispartof>Internal medicine journal, 2024-02, Vol.54 (2), p.250-257</ispartof><rights>2023 Royal Australasian College of Physicians.</rights><rights>2024 Royal Australasian College of Physicians</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3139-dde457d92aea12adbe3fcf9967128ddbd8ddf1654d5d05663bfe067c49609d383</cites><orcidid>0000-0002-5405-7681 ; 0000-0003-0466-4915</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fimj.16149$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fimj.16149$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37287100$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ow, Tsai‐Wing</creatorcontrib><creatorcontrib>Angelica, Bianca</creatorcontrib><creatorcontrib>Burn, Sophie</creatorcontrib><creatorcontrib>Chu, Matthew</creatorcontrib><creatorcontrib>Lee, Shawn Z.</creatorcontrib><creatorcontrib>Lin, Richard</creatorcontrib><creatorcontrib>Tran, Vy</creatorcontrib><creatorcontrib>Iyngkaran, Guru</creatorcontrib><creatorcontrib>Bampton, Peter</creatorcontrib><creatorcontrib>Sukocheva, Olga</creatorcontrib><creatorcontrib>Tse, Edmund</creatorcontrib><creatorcontrib>Rayner, Chris K.</creatorcontrib><title>Comparing the resource implications of old and new colorectal adenoma surveillance guidelines in Australia</title><title>Internal medicine journal</title><addtitle>Intern Med J</addtitle><description>Background
The latest update to the Australian adenoma surveillance guideline in 2018 introduced a novel risk stratification system with updated surveillance recommendations. The resource implications of adopting this new system are unclear.
Aims
To quanitfy the resource demands of adopting new over old adenoma surveillance guidelines.
Methods
We studied data from 2443 patients undergoing colonoscopies, in which a clinically significant lesion was identified in their latest, or previous procedure(s) across five Australian hospitals. We excluded procedures with inflammatory bowel disease, new or prior history of colorectal cancer or resection, inadequate bowel preparation and incomplete procedures. Old and new Australian surveillance intervals were calculated according to the number, size and histological characteristics of lesions identified. We used these data to compare the rate of procedures according to each guideline.
Results
Based on the procedures for 766 patients, the new surveillance guidelines significantly increased the number of procedures allocated an interval of 1 year (relative risk (RR): 1.57, P = 0.009) and 10 years (RR: 3.83, P < 0.00001) and reduced those allocated to half a year (RR: 0.08, P = 0.00219), 3 years (RR: 0.51, P < 0.00001) and 5 years (RR: 0.59, P < 0.00001). Overall, this reduced the relative number of surveillance procedures by 21% over 10 years (25.92 vs 32.78 procedures/100 patient‐years), which increased to 22% after excluding patients 75 or older at the time of surveillance (19.9 vs 25.65 procedures/100 patient‐years).
Conclusion
The adoption of the latest Australian adenoma surveillance guidelines can reduce demand for surveillance colonoscopy by more than a fifth (21–22%) over 10 years.</description><subject>Adenoma</subject><subject>bowel cancer prevention</subject><subject>colonoscopy</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>economic modelling</subject><subject>health resources</subject><subject>Inflammatory bowel diseases</subject><subject>Intestine</subject><subject>Patients</subject><subject>polyp surveillance</subject><subject>Surveillance</subject><subject>surveillance guidelines</subject><subject>Tumors</subject><issn>1444-0903</issn><issn>1445-5994</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp1kbtOBDEMRSME4l3wAygSDRQDec3MpkQrngLRQB1lEw9klUmWZIYVf09ggQIJF7aL4yvbF6EDSk5piTPXz09pQ4VcQ9tUiLqqpRTrX72oiCR8C-3kPCeEtlyKTbTFWzZpKSHbaD6N_UInF57x8AI4QY5jMoBdv_DO6MHFkHHscPQW62BxgCU20ccEZtAeawsh9hrnMb2B816HMvs8OgveBcjYBXw-5iFp7_Qe2ui0z7D_XXfR0-XF4_S6unu4upme31WGUy4ra0HUrZVMg6ZM2xnwznRSNi1lE2tntqSONrWwtSV10_BZB6RpjZANkZZP-C46XukuUnwdIQ-qd9nA53IQx6zYhHEpCWt4QY_-oPNyfijbKSZZ3ZZ_sbZQJyvKpJhzgk4tkut1eleUqE8DVDFAfRlQ2MNvxXHWg_0lfz5egLMVsHQe3v9XUjf3tyvJD_wWkMg</recordid><startdate>202402</startdate><enddate>202402</enddate><creator>Ow, Tsai‐Wing</creator><creator>Angelica, Bianca</creator><creator>Burn, Sophie</creator><creator>Chu, Matthew</creator><creator>Lee, Shawn Z.</creator><creator>Lin, Richard</creator><creator>Tran, Vy</creator><creator>Iyngkaran, Guru</creator><creator>Bampton, Peter</creator><creator>Sukocheva, Olga</creator><creator>Tse, Edmund</creator><creator>Rayner, Chris K.</creator><general>John Wiley & Sons Australia, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5405-7681</orcidid><orcidid>https://orcid.org/0000-0003-0466-4915</orcidid></search><sort><creationdate>202402</creationdate><title>Comparing the resource implications of old and new colorectal adenoma surveillance guidelines in Australia</title><author>Ow, Tsai‐Wing ; Angelica, Bianca ; Burn, Sophie ; Chu, Matthew ; Lee, Shawn Z. ; Lin, Richard ; Tran, Vy ; Iyngkaran, Guru ; Bampton, Peter ; Sukocheva, Olga ; Tse, Edmund ; Rayner, Chris K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3139-dde457d92aea12adbe3fcf9967128ddbd8ddf1654d5d05663bfe067c49609d383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adenoma</topic><topic>bowel cancer prevention</topic><topic>colonoscopy</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>economic modelling</topic><topic>health resources</topic><topic>Inflammatory bowel diseases</topic><topic>Intestine</topic><topic>Patients</topic><topic>polyp surveillance</topic><topic>Surveillance</topic><topic>surveillance guidelines</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ow, Tsai‐Wing</creatorcontrib><creatorcontrib>Angelica, Bianca</creatorcontrib><creatorcontrib>Burn, Sophie</creatorcontrib><creatorcontrib>Chu, Matthew</creatorcontrib><creatorcontrib>Lee, Shawn Z.</creatorcontrib><creatorcontrib>Lin, Richard</creatorcontrib><creatorcontrib>Tran, Vy</creatorcontrib><creatorcontrib>Iyngkaran, Guru</creatorcontrib><creatorcontrib>Bampton, Peter</creatorcontrib><creatorcontrib>Sukocheva, Olga</creatorcontrib><creatorcontrib>Tse, Edmund</creatorcontrib><creatorcontrib>Rayner, Chris K.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Internal medicine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ow, Tsai‐Wing</au><au>Angelica, Bianca</au><au>Burn, Sophie</au><au>Chu, Matthew</au><au>Lee, Shawn Z.</au><au>Lin, Richard</au><au>Tran, Vy</au><au>Iyngkaran, Guru</au><au>Bampton, Peter</au><au>Sukocheva, Olga</au><au>Tse, Edmund</au><au>Rayner, Chris K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparing the resource implications of old and new colorectal adenoma surveillance guidelines in Australia</atitle><jtitle>Internal medicine journal</jtitle><addtitle>Intern Med J</addtitle><date>2024-02</date><risdate>2024</risdate><volume>54</volume><issue>2</issue><spage>250</spage><epage>257</epage><pages>250-257</pages><issn>1444-0903</issn><eissn>1445-5994</eissn><abstract>Background
The latest update to the Australian adenoma surveillance guideline in 2018 introduced a novel risk stratification system with updated surveillance recommendations. The resource implications of adopting this new system are unclear.
Aims
To quanitfy the resource demands of adopting new over old adenoma surveillance guidelines.
Methods
We studied data from 2443 patients undergoing colonoscopies, in which a clinically significant lesion was identified in their latest, or previous procedure(s) across five Australian hospitals. We excluded procedures with inflammatory bowel disease, new or prior history of colorectal cancer or resection, inadequate bowel preparation and incomplete procedures. Old and new Australian surveillance intervals were calculated according to the number, size and histological characteristics of lesions identified. We used these data to compare the rate of procedures according to each guideline.
Results
Based on the procedures for 766 patients, the new surveillance guidelines significantly increased the number of procedures allocated an interval of 1 year (relative risk (RR): 1.57, P = 0.009) and 10 years (RR: 3.83, P < 0.00001) and reduced those allocated to half a year (RR: 0.08, P = 0.00219), 3 years (RR: 0.51, P < 0.00001) and 5 years (RR: 0.59, P < 0.00001). Overall, this reduced the relative number of surveillance procedures by 21% over 10 years (25.92 vs 32.78 procedures/100 patient‐years), which increased to 22% after excluding patients 75 or older at the time of surveillance (19.9 vs 25.65 procedures/100 patient‐years).
Conclusion
The adoption of the latest Australian adenoma surveillance guidelines can reduce demand for surveillance colonoscopy by more than a fifth (21–22%) over 10 years.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>37287100</pmid><doi>10.1111/imj.16149</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-5405-7681</orcidid><orcidid>https://orcid.org/0000-0003-0466-4915</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1444-0903 |
| ispartof | Internal medicine journal, 2024-02, Vol.54 (2), p.250-257 |
| issn | 1444-0903 1445-5994 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2823990263 |
| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Adenoma bowel cancer prevention colonoscopy Colorectal cancer Colorectal carcinoma economic modelling health resources Inflammatory bowel diseases Intestine Patients polyp surveillance Surveillance surveillance guidelines Tumors |
| title | Comparing the resource implications of old and new colorectal adenoma surveillance guidelines in Australia |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-07T04%3A06%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Comparing%20the%20resource%20implications%20of%20old%20and%20new%20colorectal%20adenoma%20surveillance%20guidelines%20in%20Australia&rft.jtitle=Internal%20medicine%20journal&rft.au=Ow,%20Tsai%E2%80%90Wing&rft.date=2024-02&rft.volume=54&rft.issue=2&rft.spage=250&rft.epage=257&rft.pages=250-257&rft.issn=1444-0903&rft.eissn=1445-5994&rft_id=info:doi/10.1111/imj.16149&rft_dat=%3Cproquest_cross%3E2925717327%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2925717327&rft_id=info:pmid/37287100&rfr_iscdi=true |