Patient Preferences of a Resect and Discard Paradigm
| Status: | Completed |
|---|---|
| Conditions: | Colorectal Cancer, Gastrointestinal |
| Therapuetic Areas: | Gastroenterology, Oncology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 5/12/2017 |
| Start Date: | June 2012 |
| End Date: | November 2, 2015 |
The investigators conducted a study "Resect and Discard Diminutive Polyps: a new paradigm"
(IRB ID # 201105473) from September, 2011 to July, 2013. This study examined whether doctors
performing colonoscopy are accurate enough at predicting histology of small colorectal
polyps, such that these small polyps could be resected and discarded (instead of being sent
to pathology). One of the main advantages of this approach is significant cost savings by
reducing pathology costs associated with screening and surveillance colonoscopy. A
disadvantage is that there is a 0.03% chance that small polyps contain cancer. There is no
data regarding patient preferences toward this approach. The investigators therefore
designed a patient survey to determine the patient's view toward this approach.
(IRB ID # 201105473) from September, 2011 to July, 2013. This study examined whether doctors
performing colonoscopy are accurate enough at predicting histology of small colorectal
polyps, such that these small polyps could be resected and discarded (instead of being sent
to pathology). One of the main advantages of this approach is significant cost savings by
reducing pathology costs associated with screening and surveillance colonoscopy. A
disadvantage is that there is a 0.03% chance that small polyps contain cancer. There is no
data regarding patient preferences toward this approach. The investigators therefore
designed a patient survey to determine the patient's view toward this approach.
The American Society of Gastrointestinal Endoscopy (ASGE) published a review article on a
new paradigm in colorectal cancer screening termed "resect and discard". This new paradigm
challenges the current practice of sending all colorectal polyps, regardless of appearance
or size, to pathology for analysis. "Resect and Discard" describes a new approach in which
small polyps could be removed, but be discarded instead of sent for pathology analysis. This
is based on data showing that gastroenterologists can predict the pathology of small
colorectal polyps with 80-90% accuracy, and that discarding small polyps would not alter
surveillance recommendations.
Neither the ASGE document nor published research, however, assessed patient attitudes toward
this approach. This study surveyed patients prior to first time screening colonoscopy, in
order to determine their preferences about the resect and discard approach; specifically
would patients be willing to pay for pathology analysis of small colorectal polyps with
their own money, and what factors influence their decision. We also inquired about factors
that would influence their decision to pay/not pay pathology costs themselves.
new paradigm in colorectal cancer screening termed "resect and discard". This new paradigm
challenges the current practice of sending all colorectal polyps, regardless of appearance
or size, to pathology for analysis. "Resect and Discard" describes a new approach in which
small polyps could be removed, but be discarded instead of sent for pathology analysis. This
is based on data showing that gastroenterologists can predict the pathology of small
colorectal polyps with 80-90% accuracy, and that discarding small polyps would not alter
surveillance recommendations.
Neither the ASGE document nor published research, however, assessed patient attitudes toward
this approach. This study surveyed patients prior to first time screening colonoscopy, in
order to determine their preferences about the resect and discard approach; specifically
would patients be willing to pay for pathology analysis of small colorectal polyps with
their own money, and what factors influence their decision. We also inquired about factors
that would influence their decision to pay/not pay pathology costs themselves.
Inclusion Criteria:
• Indication for colonoscopy is screening or routine polyp surveillance
Exclusion Criteria:
- Indication for colonoscopy other than screening or surveillance
- Colon cancer identified at time of colonoscopy
- Known polyposis syndrome, or polyposis identified at colonoscopy
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