Aaron Lit, MD1, Daniel Basta, MD2, Lindsey Immers, BS3, Sarah Rahni, DO, MBA1, Maxwell Charlat, MD1, Emily Shteynberg, BA4, Edward Lebovics, MD1 1Westchester Medical Center, Valhalla, NY; 2Westchester Medical Center, Elmwood Park, NJ; 3New York Medical College - - New York, NY, Valhalla, NY; 4New York Medical College, Valhalla, NY Introduction: Patients with Ulcerative Colitis (UC) and Crohn’s Colitis (CC) are at an increased risk of developing colorectal cancer (CRC). In a 2021 clinical practice update, the American Gastroenterological Association (AGA) recommends surveillance colonoscopy at varying intervals (1, 2-3, or 5 years) to assess for colonic dysplasia or CRC. The recommended interval depends on risk factors such as medical/family history, extent of inflammation, and history of dysplasia. This study evaluated adherence to these guidelines at Westchester Medical Center (WMC). Methods: A retrospective chart review was conducted for patients aged ≥ 18 years with UC or CC who received a colonoscopy for dysplasia/CRC surveillance between October 2021 and July 2024. Patients were eligible if they were diagnosed ≥ 8 years prior to colonoscopy, or at the time of diagnosis if they also had primary sclerosing cholangitis (PSC). All procedures were performed with high-resolution colonoscopes, with both targeted and random biopsies. Endoscopic, histologic, laboratory, and historical data were collected. The recommended surveillance interval was assessed based on AGA guidelines and was compared to the interval documented on the endoscopy report. Descriptive statistics were used for analysis. Results: Of 311 charts reviewed, 113 met inclusion criteria. 63 were male (56%). Ages ranged from 20 to 83 (median 51). 54 were diagnosed with UC (48%) and 57 with CC (50%). 12 had PSC (11%), 7 had history of colonic dysplasia (6%), and 6 had first degree relative with CRC history (5%). On colonoscopy, 15 had evidence of moderate/severe mucosal inflammation (13%), 5 had dense pseudopolyps (4%), and 24 had mucosal scarring (21%). On histology, 35 had active inflammation (31%) and 1 had dysplasia (1%). 70 patients (62%) had a documented surveillance interval for next colonoscopy; of these, 43 were concordant with the AGA guideline (61%). Among discordant cases, 26 were recommended a repeat colonoscopy earlier than the AGA guideline recommends (96%). Discussion: Our findings demonstrate suboptimal documentation and adherence to AGA-recommended surveillance intervals for patients with UC and CC undergoing CRC surveillance at WMC. When documented on endoscopy reports, surveillance intervals were often shorter than AGA guideline recommendations, potentially leading to unnecessary procedures and increased resource utilization. We propose targeted interventions such as EMR-based prompts and educational outreach to improve adherence to AGA guidelines.
Figure: Among patients meeting inclusion criteria, a higher percentage were recommended a 1-year surveillance colonoscopy interval in the endoscopy report compared to AGA guideline recommendations. Conversely, a lower percentage were recommended a 5-year interval than would be expected based on AGA guidelines.
Disclosures: Aaron Lit indicated no relevant financial relationships. Daniel Basta indicated no relevant financial relationships. Lindsey Immers indicated no relevant financial relationships. Sarah Rahni indicated no relevant financial relationships. Maxwell Charlat indicated no relevant financial relationships. Emily Shteynberg indicated no relevant financial relationships. Edward Lebovics indicated no relevant financial relationships.
Aaron Lit, MD1, Daniel Basta, MD2, Lindsey Immers, BS3, Sarah Rahni, DO, MBA1, Maxwell Charlat, MD1, Emily Shteynberg, BA4, Edward Lebovics, MD1. P5413 - Adherence to Colon Cancer and Dysplasia Surveillance Guidelines Among Patients With Ulcerative Colitis and Crohn's Colitis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
