The New York City Colonoscopy Quality Benchmarking Group: Screening Colonoscopy Data on Follow-Up Interval Recommendations: 2048

Introduction: In 2003, NYC launched an aggressive colorectal cancer screening campaign, recommending colonoscopy as the preferred mode. Screening rates increased from 42% (2003) to 69% (2012). To ensure the quality of screening colonoscopies, the NYC Department of Health and Mental Hygiene (DOHMH) collects colonoscopy quality data including interval recommendations. We describe the screening colonoscopy follow-up interval recommendations of a sample of local gastroenterologists. Methods: The NYC Colonoscopy Quality Benchmarking Group (CQBG) was created with support from the CDC and New York State Department of Health in 2011 in response to the need for data on colonoscopy quality. The group is led by the DOHMH in partnership with the Citywide Colon Cancer Control Coalition (C5) and The New York Society for Gastrointestinal Endoscopy. The goal was to create a citywide database to support local practices in ongoing quality improvement. CQBG partnered with GIQuIC, a national colonoscopy quality database, to collect clinical data. Practice sites were recruited voluntarily. DOHMH provides sites with de-identified quarterly benchmarking reports tracking 8 evidence-based quality measures (e.g., adenoma detection rate) that allow comparison of endoscopist performance within and between sites. Recommended follow-up interval after screening colonoscopy is also reported. Colonoscopy was classified as negative if no biopsy or polypectomy was performed. Results: Two hundred twenty-eight endoscopists submitted data for 22,000 screening colonoscopies from 16 sites (11 ambulatory surgery centers, 4 hospitals, 1 office practice). Recommended follow-up interval data were pooled from 7 sites from October 2012 to September 2013. In individuals with negative screening colonoscopies, more than half were recommended a follow-up interval within 5 years and only 20.4% were given a 10-year interval (Table 1).Table 1: Screening Colonoscopy Follow-up Interval Recommendations, N=4,877Conclusion: Our data show that the majority of patients undergoing screening colonoscopy are instructed to have a follow-up colonoscopy in 5 years or less. The shorter interval was not due to inadequate bowel preparations or failure to reach the cecum. Overuse of colonoscopy can have adverse effects such as increased procedure complications, inflated health care costs, and reduced availability of resources. A high degree of non-adherence to current screening colonoscopy interval guidelines is apparent and further studies will be directed to underlying factors. Disclosure - Steven Itzkowitz, MD, FACG- Scientific Advisory Board and Exact Sciences Corp. Felice Schnoll-Sussman, MD, FACG- Given Imaging: Advisory Board, Cdx: Advisory Board.