Assessment of Patientsʼ Recollection of Polyp Findings on Colonoscopy

Abstract

Purpose: Current ACG guidelines for colorectal cancer (CRC) screening and surveillance require knowledge of a patient's personal and family history of CRC and adenomas, including age of onset, size, number and pathology of polyps. Which details a patient remembers regarding their colonoscopy findings is unknown. Our aims are to determine the accuracy of patients' knowledge regarding the findings on their last colonoscopy and establish if any factors including method of communicating results influenced their ability to correctly recall the findings. Methods: A 35 question survey was administered to individuals who previously had a colonoscopy at our Center. Questions included information on demographics, absence/presence of polyps, polyp size (1-5, 6-9, >9mm), number and pathology (by specific histology). Other and unsure were response options. We compared participants' survey responses to colonoscopy and pathology reports and electronic medical records (EMR). Subjects who correctly recalled presence of polyps were studied to determine how many of the 3 key polyp features they reported correctly; number (1-2 or > 2), size of largest polyp (1-9 mm or > 9 mm) and pathology of at least 1 polyp. The effect of method of communication of results on correct recall of colonoscopy findings was assessed. Results: 233 individuals (median age 55, 49% men) participated in this IRB approved study. 82% correctly recalled the presence/absence of polyp(s) [Table]. 9% reporting polyps did not have them and 3% reporting no polyps had them. Of 118 correctly reporting polyps, 61% correctly recalled number of polyps, 26% polyp size, and 74% were unsure of pathology. 37% of individuals did not correctly recall at least one of the 3 key polyp features while 39% were correct on 1, 16% on 2 and 8% recalled 3. Neither age at last colonoscopy, current age, gender or method of communication of colonoscopy results significantly influenced accurate reporting of presence of polyp(s) or number of key polyp features (p > 0.05). Less years since last colonoscopy, 3 vs 4.3 (p=0.037) and presence of polyps on last colonoscopy (p <0.001) were associated with correct self report of presence/absence of polyps.Table: No Caption available.Conclusion: Only 82% of patients correctly remember the presence/absence of polyp(s). Key polyp features important in determining surveillance intervals are not recalled by patients. Methods to improve a patient's ability to retain details of personal colonoscopy findings is an important area of quality improvement in colonoscopy.