1163 Proximal Advanced Adenomas are More Common Among Urban Hispanics Than African Americans Undergoing Average-Risk Screening Colonoscopy

Purpose We evaluated the Colorectal Cancer (CRC) Oncology Watch intervention, a clinical reminder implemented in Veterans Integrated Service Network 7 (including eight hospitals) to improve CRC screening rates in 2008. Patients and Methods Veterans Affairs (VA) administrative data were used to construct four cross-sectional groups of veterans at average risk, age 50 to 64 years; one group was created for each of the following years: 2006, 2007, 2009, and 2010. We applied hospital fixed effects for estimation, using a difference-in-differences model in which the eight hospitals served as the intervention sites, and the other 121 hospitals served as controls, with 2006 to 2007 as the preintervention period and 2009 to 2010 as the postintervention period. Results The sample included 4,352,082 veteran-years in the 4 years. The adherence rates were 37.6%, 31.6%, 34.4%, and 33.2% in the intervention sites in 2006, 2007, 2009, and 2010, respectively, and the corresponding rates in the controls were 31.0%, 30.3%, 32.3%, and 30.9%. Regression analysis showed that among those eligible for screening, the intervention was associated with a 2.2–percentage point decrease in likelihood of adherence (P < .001). Additional analyses showed that the intervention was associated with a 5.6–percentage point decrease in likelihood of screening colonoscopy among the adherent, but with increased total colonoscopies (all indicators) of 3.6 per 100 veterans age 50 to 64 years. Conclusion The intervention had little impact on CRC screening rates for the studied population. This absence of favorable impact may have been caused by an unintentional shift of limited VA colonoscopy capacity from average-risk screening to higher-risk screening and to CRC surveillance, or by physician fatigue resulting from the large number of clinical reminders implemented in the VA.

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High Definition Colonoscopy Combined with i-SCAN Imaging Technology Is Superior in the Detection of Adenomas and Advanced Lesions Compared to High Definition Colonoscopy Alone

Diagnostic and Therapeutic Endoscopy ◽

10.1155/2015/167406 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 8

Author(s):

Erik A. Bowman ◽

Patrick R. Pfau ◽

Arnab Mitra ◽

Mark Reichelderfer ◽

Deepak V. Gopal ◽

...

Keyword(s):

White Light ◽

Outcome Measurement ◽

Screening Colonoscopy ◽

Average Risk ◽

High Definition ◽

Polyp Size ◽

Endoscopic Screening ◽

White Light Endoscopy ◽

Adenoma Detection ◽

Advanced Adenomas

Background. Improved detection of adenomatous polyps using i-SCAN has mixed results in small studies. Utility of i-SCAN as a primary surveillance modality for colorectal cancer screening during colonoscopy is uncertain. Aim. Comparing high definition white light endoscopy (HDWLE) to i-SCAN in their ability to detect adenomas during colonoscopy. Methods. Prospective cohort study of 1936 average risk patients who had a screening colonoscopy at an ambulatory procedure center. Patients underwent colonoscopy with high definition white light endoscopy withdrawal versus i-SCAN withdrawal during endoscopic screening exam. Primary outcome measurement was adenoma detection rate for i-SCAN versus high definition white light endoscopy. Secondary measurements included polyp size, pathology, and morphology. Results. 1007 patients underwent colonoscopy with i-SCAN and 929 with HDWLE. 618 adenomas were detected in the i-SCAN group compared to 402 in the HDWLE group p<0.01. More advanced adenomas (≥10 mm) were found by i-SCAN, 79 versus 47 p=0.021 and based upon histology alone 37 versus 18 p=0.028. Conclusions. i-SCAN detected significantly more adenomas and advanced adenomas compared to high definition white light endoscopy.

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Su1715 Prevalence and Risk Factors for the Presence of Sessile Serrated Polyps During First Time Average Risk Screening Colonoscopy

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2017.03.944 ◽

2017 ◽

Vol 85 (5) ◽

pp. AB407

Author(s):

Abhiram Duvvuri ◽

Sreekar Vennelaganti ◽

Ramprasad Jegadeesan ◽

Babak Gachpaz ◽

Prashanth Vennalaganti ◽

...

Keyword(s):

Risk Factors ◽

Screening Colonoscopy ◽

Average Risk ◽

Risk Screening ◽

Serrated Polyps ◽

Time Average ◽

First Time

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The Prevalence of Adenomas, AAs, and CRCs in Colonoscopy Screening Among Average-Risk Individuals in China

10.21203/rs.3.rs-777891/v1 ◽

2021 ◽

Author(s):

Yan Gong ◽

Yansong Zheng ◽

Rilige Wu ◽

Miao Liu ◽

Hong Li ◽

...

Keyword(s):

Age Groups ◽

Screening Colonoscopy ◽

Average Risk ◽

Number Of Patients ◽

High Prevalence ◽

Male Sex ◽

Advanced Adenomas ◽

Old Men ◽

Number Of Individuals ◽

Serrated Adenomas

Abstract Background: Screening colonoscopy has historically been recommended starting at the age of 50. However, the recommended age for beginning screening has recently been reduced to 45 independent of sex. However, studies on screening colonoscopies of average-risk individuals in China are sparse. This study aimed to determine and compare the prevalence of adenomas, advanced adenomas (AAs), and colorectal cancers (CRCs) and the number of individuals needing screening in an average-risk Chinese population of different ages and sexes.Methods: A total of 53,152 individuals undergoing colonoscopy were included from January 2013 to December 2019. We analysed and compared the prevalence of adenomas, AAs, and CRCs and the number of individuals needing screening in different age groups of men and women.Results: The average age of males was 48.80 years (SD, 8.47 years), that of females was 50.00 years (SD, 9.00 years), and the sex ratio was 66.28% (n=35,226) vs. 33.72% (n=17,926). The prevalence of adenomas, AAs, serrated adenomas and CRCs was 14.51% ([95% CI 14.21–14.81], n=7713), 3.04% ([95% CI 2.90–3.19], n=1617), 1.23% ([95% CI 1.01–1.32], n=653) and 0.59% ([95% CI 0.52–0.65], n=313), respectively. Male sex was significantly associated with a high prevalence of adenomas (17.14% [95% CI 16.74–17.53] vs 9.36% [95% CI 8.94–9.79], P<0.001), AAs (3.67% [95% CI 3.47–3.87] vs 1.81% [95% CI 1.61–2.00], P<0.001) and serrated adenomas (1.56% [95% CI 1.43–1.69] vs. 0.59% [95% CI 0.47–0.70], P<0.001). The prevalence of AAs in 45- to 49-year-old individuals was 3.17% (95% CI 2.80–3.55) in men and 1.49% (95% CI 1.12–1.86) in women. The number of men needing screening(NNS) was 31.55 (95% CI 28.17–35.71), while the number of women was 67.11 (95% CI 53.76–89.29). The prevalence and number of patients needing screening for AAs in men aged 45–49 years were close to those in women aged 65–69 years (31.55 [95% CI, 28.17–35.71] vs. 29.07 [95% CI, 21.05–46.73]).Conclusions: The prevalence of adenomas, AAs, and serrated adenomas increased with age. Males had a higher prevalence rate than females. The prevalence and NNS of AAs in 45- to 49-year-old men were close to those in 65- to 69-year-old women.

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