Evaluating the impact of 2020 post polypectomy surveillance guidelines in the Northern Ireland bowel cancer screening programme

We note with interest the new postpolypectomy and postcolorectal cancer resection surveillance guidelines by Rutter et al , representing an overdue update on preceding guidelines originally published in 2002 and last revised in 2010.1–3 The new guidelines include evidence from the English bowel cancer screening programme (BCSP) and, for the first time, address risk stratification in individuals found to have both adenomas and serrated polyps. An age cut-off for surveillance is recommended. The overarching guidance is towards more selective and less frequent surveillance, focusing limited resources on those most in need.\n\nWe have examined data from the Northern Ireland (NI) BCSP, to ascertain the potential impact of introducing the new guidelines. The NIBCSP has maintained a pathology database of all endoscopic specimens procured at screening-related index and surveillance colonoscopies, since inception of the faecal occult blood (FOB)-based programme in 2010. In parallel, a Bowel Screening Information Management System collates participant level endoscopy findings …