Patient Attitudes Toward Lengthening Colonoscopy Interval After Low-Risk Adenomas

Patients with one or two tubular adenomas <10 mm in size with low-grade dysplasia are said to have low-risk adenomas, and in the current surveillance guideline, they are recommended to undergo follow-up at 5 to 10 years. Most U.S. endoscopists advise these patients to undergo colonoscopy at 5 years, although the yield of surveillance is low.

In a survey of some 350 Veterans Administration hospital patients with low-risk adenomas (aged 60–89 years; 98% male), participants were presented with a hypothetical scenario in which a provider informs a patient due for a surveillance exam about the low risk for colorectal cancer. They then answered questions about their attitudes toward a 5-year versus 10-year interval for surveillance. Results were as follows:

• The majority (89%) were interested in a 5-year surveillance interval, but 45% were comfortable waiting 10 years if recommended by their physician.

• Trust in physicians was associated with a higher comfort level for waiting 10 years, and perceived effectiveness of colonoscopy and greater worry about colorectal cancer were associated with a lower comfort level.

• Half of respondents were comfortable stopping surveillance for poor health.

• Factors associated with less comfort with stopping included worrying about colorectal cancer (odds ratio, 0.7), perceived effectiveness of colonoscopy (OR, 0.8), and black race (OR, 0.4).