Variation in Treatment of Colorectal Polyp Cancers
Author Information
Author(s): Hallam Sally, Farrugia Alexia, Naumann David N., Trudgill Nigel, Rout Shantanu, Karandikar Sharad
Primary Institution: University Hospitals Birmingham
Hypothesis
There would be significant variations in practice between sites even in the same city, and that these variations would be associated with differences in endoscopic assessment and pathology reporting and threshold to operate.
Conclusion
There was significant variation in the assessment and treatment of colonic polyp cancers.
Supporting Evidence
- 81% of patients underwent primary endoscopic resection.
- 30% of patients required secondary surgical excision.
- Only the size of colonic polyps was associated with primary surgery rather than endoscopic polypectomy.
Takeaway
Doctors treat colon polyps differently, and this study looked at how they do it in one city. They found that some patients get different treatments even when they have the same type of polyp.
Methodology
A retrospective observational study using data from the Bowel Cancer Screening Programme over an 11-year period, comparing management across four hospital sites.
Potential Biases
The decision-making process for treatment was not always clear, which may introduce bias.
Limitations
The study has a small cohort and is retrospective, relying on the quality of documentation in endoscopy reports.
Participant Demographics
Median age was 73 years, with 75% male participants.
Statistical Information
P-Value
0.038
Confidence Interval
95% CI 1.00–1.11
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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