IDDF2022-ABS-0143 Colonoscopic Polypectomy Preferences among Gastrointestinal Endoscopists in the Philippines: Results of an Online Survey-Based Cross-Sectional Study

Background To date, no study has investigated colonoscopic polypectomy preferences among endoscopists in the Philippines. This study aimed to assess current practices of endoscopists on polypectomy during colonoscopy and to determine the factors associated with adherence to recent polypectomy guidelines, particularly on cold snare polypectomy (CSP) for diminutive and small polyps – a subset of polyps for which recommendations have the most robust evidence at present. These results may streamline local educational activities both for experienced and novice colonoscopists to optimize the utility of colonoscopy in preventing colorectal cancer (CRC). Methods An online survey designed by local expert gastroenterologists to address this topic was conducted using Google Forms, a web-based survey platform. All gastrointestinal endoscopists in the Philippines were eligible. Descriptive statistics, Chi-square test, Fisher’s exact test, and logistic regression were used for statistical analysis. Results 105 responses were included in the final analysis. The following most preferred polypectomy techniques were noted for each corresponding polyp scenario: cold forceps polypectomy for 1–3mm sessile polyps (74%); CSP for 4–5mm sessile polyps (39%); CSP and hot snare polypectomy (HSP) equally favored for 6–9mm sessile polyps (34%); endoscopic mucosal resection (EMR) for benign sessile polyps >10mm (38%); referral to an expert endoscopist for EMR or ESD for suspicious malignant polyps (53%); and HSP for pedunculated polyps (75–80%). Factors associated with the use of CSP for sessile polyps <10mm were the following: attendance to workshops on image-enhanced endoscopy (IEE) (p=0.025); location of practice (p<0.001); endoscopists’ confidence in using IEE (p=0.013) and adhering to guidelines (0.007); number of colonoscopies performed in a year (p=0.033); and brand of scope used (p<0.001). Conclusions To date, this was the first study to describe colonoscopic polypectomy preferences among GI endoscopists in the Philippines. Adherence to CSP for small or diminutive polyps was generally very poor. Based on these identified factors, holding more workshops on polypectomy and IEE, directed especially to endoscopists in areas outside the National Capital Region and those who perform fewer colonoscopies, may improve adherence to the most recent evidence-based polypectomy guidelines.