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Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Dec 7, 2006; 12(45): 7313-7318
Published online Dec 7, 2006. doi: 10.3748/wjg.v12.i45.7313
Non-compliance in surveillance for patients with previous resection of large (≥ 1 cm) colorectal adenomas
Wolfgang M Brueckl, Berit Fritsche, Brigitte Seifert, Frank Boxberger, Heinz Albrecht, Roland S Croner, Axel Wein, Eckhart G Hahn
Wolfgang M Brueckl, Berit Fritsche, Brigitte Seifert, Frank Boxberger, Heinz Albrecht, Axel Wein, Eckhart G Hahn, Department of Medicine 1, University Hospital of Erlangen, 91054 Erlangen, Germany
Roland S Croner, Department of Surgery, University Hospital of Erlangen, 91054 Erlangen, Germany
Supported by a grant from the ELAN-Program of the FAU Erlangen, Germany, No. 00.05.31.1
Correspondence to: Wolfgang M Brueckl, MD, PhD, Depart-ment of Medicine 1, University Hospital of Erlangen, Ulmenweg 18, 91054 Erlangen, Germany. wolfgang.brueckl@med1.imed.uni-erlangen.de
Telephone: +49-9131-8535000 Fax: +49-9131-8535062
Received: August 18, 2006
Revised: August 28, 2006
Accepted: October 20, 2006
Published online: December 7, 2006
Abstract

AIM: To assess the extent and reasons of non-compliance in surveillance for patients undergoing polypectomy of large (≥ 1 cm) colorectal adenomas.

METHODS: Between 1995 and 2002, colorectal adenomas ≥ 1 cm were diagnosed in 210 patients and subsequently documented at the Erlangen Registry of Colorectal Polyps. One hundred and fifty-eight patients (75.2%) could be contacted by telephone and agreed to be interviewed. Additionally, records were obtained from the treating physicians.

RESULTS: Fifty-four out of 158 patients (34.2%) neglected any surveillance. Reasons for non-compliance included lack of knowledge concerning surveillance intervals (45.8%), no symptoms (29.2%), fear of examination (18.8%) or old age/severe illness (6.3%). In a multivariate analysis, the factors including female gender (P = 0.036) and age > 62 years (P = 0.016) proved to be significantly associated with non-compliance in surveillance.

CONCLUSION: Efforts to increase compliance in surveillance are of utmost importance. This applies particularly to women’s compliance. Effective strategies for avoiding metachronous colorectal adenoma and cancer should focus on both the improvement in awareness and knowledge of patients and information about physicians for surveillance.

Keywords: Colorectal adenoma; Colorectal cancer; Surveillance colonoscopy; Non-compliance