A recently published study in MedPage Today spelled out the importance of receiving a quality colonoscopy and shows that compliance to follow up colonoscopy schedules is extremely important. The findings suggest that incomplete polyp removal and failure to have a follow-up colonoscopy were more strongly associated with the risk for subsequent development of colorectal cancer than were characteristics of the removed polyps. In plain English, the study says: if you have a sub-par colonoscopy where not all polyps are removed due to poor prep or where cecal intubation was not complete you are almost four times as likely to develop colorectal cancer.
This is astounding! The polyp-related factors other than multiple adenomas which the study took into consideration were the presence of a polyp larger than 1 cm in diameter, histologic findings such as villous features or high-grade dysplasia, and a polyp being found in the proximal colon. I find it so amazing that these crucial factors were not as strongly associated with the development of CRC as the quality of the screening and compliance to follow up instructions. The power to stop CRC before it develops is in our hands.
Everyone needs to be given the highest quality screening possible. The PCC issue briefs point out best practices including the use of propofol as a sedation agent for colonoscopies. Not only do physicians achieve complete exams and find more polyps while using propofol, but also the customer satisfaction rates yield better compliance to prescribed follow-up colonoscopies.