ADR Evaluation of Screening Colonoscopies During 2016 - 2017 in a Private Health Clinic in Peru

Overview

Journal Endosc Int Open

Specialty Gastroenterology

Date 2018 Nov 10

PMID 30410949

Citations 3

Authors

Julio F Leon Moreno

Affiliations

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Abstract

High-quality colonoscopy is fundamental for preventing colorectal cancer (CRC). The adenoma detection rate (ADR) is a key colonoscopy quality measure. The aim of this study was to establish the screening colonoscopy ADR of a tertiary referral center in Peru, identify the relationship between the ADR and patient age, sex and the colonoscopist, and determine the endoscopic and histopathological characteristics of the lesions found. A retrospective observational longitudinal study was undertaken between January 2016 and June 2017. Eight colonoscopists performed screening colonoscopies on 620 patients scoring ≥ 6 points on the Boston Bowel Preparation Scale (BBPS); cecal intubation was complete in 595 patients (cecal intubation rate [CIR] 95.9 %). The overall ADR was 29.7 % (females 25.4 %, males 33.1 %, = 0.040, 95 %Cl). The ADR colonoscopist range was 25.0 % to 34.4 %. The highest ADR (41.2 %, = 0.013, 95 %Cl) was for patients aged 65 to 75 years. Adenoma colon locations were: left 49 %, transverse 21.6 % and right 29.4 %. Adenoma dysplasia grades: low 98 %, high 2 %. Sixty-three percent of the lesions were 5 mm to 10 mm. Resections performed: 78.5 % cold biopsy forceps (CBF), 3.4 % cold snare polypectomy (CSP) and 18.1 % endoscopic mucosal resection (EMR). The ADR established was in line with the joint American College of Gastroenterology (ACG)/American Society for Gastrointestinal Endoscopy (ASGE) recommendations and related to patient age and gender but not to the colonoscopist. Colonoscopists should ensure rigorous application of the colonoscopy quality actions. ADR should be evaluated frequently.

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References

Kim S, Paik H, Yoon H, Lee J, Kim N, Sung M . Sex- and gender-specific disparities in colorectal cancer risk. World J Gastroenterol. 2015; 21(17):5167-75. PMC: 4419057. DOI: 10.3748/wjg.v21.i17.5167. View

Valori R, Damery S, Gavin D, Anderson J, Donnelly M, Williams J . A new composite measure of colonoscopy: the Performance Indicator of Colonic Intubation (PICI). Endoscopy. 2017; 50(1):40-51. DOI: 10.1055/s-0043-115897. View

East J, Atkin W, Bateman A, Clark S, Dolwani S, Ket S . British Society of Gastroenterology position statement on serrated polyps in the colon and rectum. Gut. 2017; 66(7):1181-1196. PMC: 5530473. DOI: 10.1136/gutjnl-2017-314005. View

Abdul-Baki H, Schoen R, Dean K, Rose S, Leffler D, Kuganeswaran E . Public reporting of colonoscopy quality is associated with an increase in endoscopist adenoma detection rate. Gastrointest Endosc. 2015; 82(4):676-82. PMC: 4575767. DOI: 10.1016/j.gie.2014.12.058. View

Abdeljawad K, Vemulapalli K, Kahi C, Cummings O, Snover D, Rex D . Sessile serrated polyp prevalence determined by a colonoscopist with a high lesion detection rate and an experienced pathologist. Gastrointest Endosc. 2014; 81(3):517-24. DOI: 10.1016/j.gie.2014.04.064. View

OConnor S, Brooklyn T, Dunckley P, Valori R, Carr R, Foy C . High complete resection rate for pre-lift and cold biopsy of diminutive colorectal polyps. Endosc Int Open. 2018; 6(2):E173-E178. PMC: 5794434. DOI: 10.1055/s-0043-121874. View

Rex D, Johnson D, Anderson J, Schoenfeld P, Burke C, Inadomi J . American College of Gastroenterology guidelines for colorectal cancer screening 2009 [corrected]. Am J Gastroenterol. 2009; 104(3):739-50. DOI: 10.1038/ajg.2009.104. View

Gohel T, Burke C, Lankaala P, Podugu A, Kiran R, Thota P . Polypectomy rate: a surrogate for adenoma detection rate varies by colon segment, gender, and endoscopist. Clin Gastroenterol Hepatol. 2013; 12(7):1137-42. DOI: 10.1016/j.cgh.2013.11.023. View

Anderson J, Butterly L, Goodrich M, Robinson C, Weiss J . Differences in detection rates of adenomas and serrated polyps in screening versus surveillance colonoscopies, based on the new hampshire colonoscopy registry. Clin Gastroenterol Hepatol. 2013; 11(10):1308-12. PMC: 3841980. DOI: 10.1016/j.cgh.2013.04.042. View

10.

Floer M, Meister T . Endoscopic Improvement of the Adenoma Detection Rate during Colonoscopy - Where Do We Stand in 2015?. Digestion. 2016; 93(3):202-13. DOI: 10.1159/000442464. View

11.

Kim J, Lee B, Choi H, Jun S, Park E, Park J . Cold snare polypectomy versus cold forceps polypectomy for diminutive and small colorectal polyps: a randomized controlled trial. Gastrointest Endosc. 2015; 81(3):741-7. DOI: 10.1016/j.gie.2014.11.048. View

12.

Azzoni C, Bottarelli L, Campanini N, Di Cola G, Bader G, Mazzeo A . Distinct molecular patterns based on proximal and distal sporadic colorectal cancer: arguments for different mechanisms in the tumorigenesis. Int J Colorectal Dis. 2006; 22(2):115-26. DOI: 10.1007/s00384-006-0093-x. View

13.

Marcondes F, Dean K, Schoen R, Leffler D, Rose S, Morris M . The impact of exclusion criteria on a physician's adenoma detection rate. Gastrointest Endosc. 2015; 82(4):668-75. PMC: 4575765. DOI: 10.1016/j.gie.2014.12.056. View

14.

DeMarco D, Odstrcil E, Lara L, Bass D, Herdman C, Kinney T . Impact of experience with a retrograde-viewing device on adenoma detection rates and withdrawal times during colonoscopy: the Third Eye Retroscope study group. Gastrointest Endosc. 2010; 71(3):542-50. DOI: 10.1016/j.gie.2009.12.021. View

15.

Cardoso D, Botacin M, Mekdessi M . ADENOMA DETECTION RATE EVALUATION AND QUALITY OF COLONOSCOPY IN THE CENTER-WEST REGION OF BRAZIL. Arq Gastroenterol. 2017; 54(4):315-320. DOI: 10.1590/S0004-2803.201700000-47. View

16.

Britto-Arias M, Waldmann E, Jeschek P, Gessl I, Sallinger D, Bannert C . Forceps versus snare polypectomies in colorectal cancer screening: are we adhering to the guidelines?. Endoscopy. 2015; 47(10):898-902. DOI: 10.1055/s-0034-1392328. View

17.

. The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc. 2003; 58(6 Suppl):S3-43. DOI: 10.1016/s0016-5107(03)02159-x. View

18.

Imperiale T, Glowinski E, Juliar B, Azzouz F, Ransohoff D . Variation in polyp detection rates at screening colonoscopy. Gastrointest Endosc. 2009; 69(7):1288-95. DOI: 10.1016/j.gie.2007.11.043. View

19.

Barreda Costa C, Vila Gutierrez S, Salazar Cabrera F, Barriga Calle E, Velarde Criado H, Barriga Briceno J . [Advanced adenoma in 3700 colonoscopies]. Rev Gastroenterol Peru. 2010; 30(2):113-20. View

20.

Do A, Weinberg J, Kakkar A, Jacobson B . Reliability of adenoma detection rate is based on procedural volume. Gastrointest Endosc. 2012; 77(3):376-80. DOI: 10.1016/j.gie.2012.10.023. View