Nonneoplastic polypectomy during screening colonoscopy: the impact on polyp detection rate, adenoma detection rate, and overall cost

ABSTRACT BACKGROUND: The effectiveness of colonoscopy for colorectal cancer (CRC) screening depends on quality indicators, which adenoma detection rate (ADR) being the most important. Proximal serrated polyp detection rate (pSPDR) has been studied as a potential quality indicator for colonoscopy. OBJECTIVE: The aim is to analyze and compare the difference in ADR and pSPDR between patients undergoing screening colonoscopy and an unselected population with other indications for colonoscopy, including surveillance and diagnosis. METHODS: This is a historical cohort of patients who underwent colonoscopy in the digestive endoscopy service of a tertiary hospital. Out of 1554 colonoscopies performed, 573 patients were excluded. The remaining 981 patients were divided into two groups: patients undergoing screening colonoscopy (n=428; 43.6%); patients with other indications including surveillance and diagnosis (n=553; 56.4%). RESULTS: Adenoma detection rate of the group with other indications (50.6%) was higher than that of the screening group (44.6%; P=0.03). In regarding pSPDR, there was no difference between pSPDR in both groups (screening 13.6%; other indications 13.7%; P=0.931). There was no significant difference in the mean age (P=0.259) or in the proportion of men and women (P=0.211) between both groups. CONCLUSION: Proximal serrated polyp detection rate showed an insignificant difference between groups with different indications and could be used as a complementary indicator to adenoma detection rate. This could benefit colonoscopists with low colonoscopy volume or low volume of screening colonoscopies.

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Tu2003 ESTABLISHING NEED FOR SERRATED POLYP DETECTION RATE AND ADVANCED ADENOMA DETECTION RATE BENCHMARKS AS QUALITY INDICATORS FOR SCREENING COLONOSCOPY

Gastroenterology ◽

10.1016/s0016-5085(20)33788-4 ◽

2020 ◽

Vol 158 (6) ◽

pp. S-1252

Author(s):

Shaman Dalal ◽

Aakash Desai ◽

Patrick Twohig ◽

Aun R. Shah ◽

Sara Kamionkowski ◽

...

Keyword(s):

Quality Indicators ◽

Detection Rate ◽

Adenoma Detection Rate ◽

Screening Colonoscopy ◽

Advanced Adenoma ◽

Polyp Detection ◽

Serrated Polyp ◽

Polyp Detection Rate ◽

Adenoma Detection

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Impact of propofol sedation versus opioid/benzodiazepine sedation on colonoscopy outcomes: a systematic review with meta-analysis

Endoscopy International Open ◽

10.1055/a-1135-8681 ◽

2020 ◽

Vol 08 (06) ◽

pp. E701-E707

Author(s):

Muhammad Aziz ◽

Simcha Weissman ◽

Rawish Fatima ◽

Zubair Khan ◽

Babu P. Mohan ◽

...

Keyword(s):

Systematic Review ◽

Detection Rate ◽

Meta Analysis ◽

Adenoma Detection Rate ◽

Advanced Adenoma ◽

Polyp Detection ◽

Propofol Sedation ◽

Polyp Detection Rate ◽

Adenoma Detection ◽

The Impact

Abstract Background and study aims Choice of sedation (propofol vs opioid/benzodiazepine) has been studied in the literature and has shown variable outcomes. The majority of recent studies have evaluated propofol sedation (PS) versus opioids, benzodiazepines, or a combination of both. We performed a systematic review and meta-analysis of studies comparing PS to other sedation methods to assess the impact on colonoscopy outcomes. Methods Multiple databases were searched and studies of interest were extracted. Primary outcome of the study was adenoma detection rate (ADR) and secondary outcomes included polyp detection rate (PDR), advanced adenoma detection rate (AADR), and cecal intubation rate (CIR). Results A total of 11 studies met the inclusion criteria with a total of 177,016 patients (148,753 and 28,263 in the opioids/benzodiazepine group and PS group, respectively). Overall, ADR (RR: 1.07, 95 % CI 0.99–1.15), PDR (RR: 1.01, 95 % CI 0.93–1.10), and AADR (RR: 1.17, 95 % CI 0.92–1.48) did not improve with the use of PS. The CIR was slightly higher for propofol sedation group (RR 1.02, 95 % CI 1.00–1.03). Conclusion Based on our analysis, PS and opioid/benzodiazepine sedation seem to have comparable ADR. Our results do not favor use of a particular sedation method and the choice of sedation should be individualized based on patient preference, risk factors and resource availability.

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