Post-colonoscopy colorectal cancer in Belgium: characteristics and influencing factors

Abstract Background and study aims Post-colonoscopy colorectal cancer (PCCRC) is an important quality parameter of colonoscopy. Most studies have shown that the risk for colorectal cancer is reduced after an index colonoscopy for screening or diagnostic purposes with or without polypectomy. In this study, we aimed to quantify and describe PCCRC in Belgium, including the possible relationships with patient, physician, and colonoscopy characteristics. Patients and methods Reimbursement data on colorectal related medical procedures from the Intermutualistic Agency (IMA-AIM) were linked with data on clinical and pathological staging of colorectal cancer (CRC) available at the Belgian Cancer Registry (BCR) over a period covering 9 years (2002 – 2010). Results In total, 63 518 colorectal cancers were identified in 61 616 patients between 2002 and 2010. We calculated a mean PCCRC rate of 7.6 %. PCCRC was significantly higher in older people and correlated significantly with polyp detection rate and the number of resections and procedures performed per year per physician. Conditional observed survival, given still alive 3 years since first colonoscopy, for PCCRC was worse than for CRC. Older patients and patients with invasive carcinomas had a worse outcome. Conclusions Although no quality register exists in Belgium, we were able to demonstrate that PCCRC in Belgium is directly related to the experience of the physician performing the procedure. In the absence of a quality register, utilization of population-based data sources proved to be a valuable tool to identify quality parameters.

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The effect of train-the-colonoscopy-trainer course on colonoscopy quality indicators

Endoscopy ◽

10.1055/a-1352-4583 ◽

2021 ◽

Author(s):

Geir Hoff ◽

Edoardo Botteri ◽

Gert Huppertz-Hauss ◽

Jan Magnus Kvamme ◽

Øyvind Holme ◽

...

Keyword(s):

Quality Indicators ◽

Estimating Equation ◽

First Year ◽

Polyp Detection ◽

Detection Rates ◽

Quality Register ◽

Polyp Detection Rate ◽

National Quality ◽

Systematic Training ◽

Colonoscopy Quality

Abstract Background Systematic training in colonoscopy is highly recommended; however, we have limited knowledge of the effects of “training-the-colonoscopy-trainer” (TCT) courses. Using a national quality register on colonoscopy performance, we aimed to evaluate the effects of TCT participation on defined quality indicators. Methods This observational study compared quality indicators (pain, cecal intubation, and polyp detection) between centers participating versus not participating in a TCT course. Nonparticipating centers were assigned a pseudoparticipating year to match their participating counterparts. Results were compared between first year after and the year before TCT (pseudo)participation. Time trends up to 5 years after TCT (pseudo)participation were also compared. Generalized estimating equation models, adjusted for age, sex, and bowel cleansing, were used. Results 11 participating and 11 nonparticipating centers contributed 18 555 and 10 730 colonoscopies, respectively. In participating centers, there was a significant increase in detection of polyps ≥ 5 mm, from 26.4 % to 29.2 % (P = 0.035), and reduction in moderate/severe pain experienced by women, from 38.2 % to 33.6 % (P = 0.043); no significant changes were found in nonparticipating centers. Over 5 years, 20 participating and 18 nonparticipating centers contributed 85 691 and 41 569 colonoscopies, respectively. In participating centers, polyp detection rate increased linearly (P = 0.003), and pain decreased linearly in women (P = 0.004). Nonparticipating centers did not show any significant time trend during the study period. Conclusions Participation in a TCT course improved polyp detection rates and reduced pain experienced by women. These effects were maintained during a 5-year follow-up.

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Impact of differences in adenoma and proximal serrated polyp detection rate on the long-term effectiveness of FIT-based colorectal cancer screening

BMC Cancer ◽

10.1186/s12885-018-4375-9 ◽

2018 ◽

Vol 18 (1) ◽

Author(s):

Maxime E. S. Bronzwaer ◽

Marjolein J. E. Greuter ◽

Arne G. C. Bleijenberg ◽

Joep E. G. IJspeert ◽

Evelien Dekker ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Detection Rate ◽

Polyp Detection ◽

Serrated Polyp ◽

Polyp Detection Rate

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251 – Endoscopist-Related Factors Influencing Polyp Detection Rate in a National Colorectal Cancer Screening Programme

Gastroenterology ◽

10.1016/s0016-5085(19)36895-7 ◽

2019 ◽

Vol 156 (6) ◽

pp. S-46

Author(s):

Susanne M. O’Reilly ◽

Sara McNally ◽

Therese Mooney ◽

Patricia Fitzpatrick ◽

Diarmuid O’Donoghue ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Detection Rate ◽

Screening Programme ◽

Polyp Detection ◽

Related Factors ◽

Factors Influencing ◽

Polyp Detection Rate ◽

Cancer Screening Programme

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Gaze patterns hold key to unlocking successful search strategies and increasing polyp detection rate in colonoscopy

Endoscopy ◽

10.1055/s-0044-101026 ◽

2018 ◽

Vol 50 (07) ◽

pp. 701-707 ◽

Cited By ~ 13

Author(s):

Mariam Lami ◽

Harsimrat Singh ◽

James Dilley ◽

Hajra Ashraf ◽

Matthew Edmondon ◽

...

Keyword(s):

Eye Tracking ◽

Detection Rate ◽

Surrogate Marker ◽

Polyp Detection ◽

Gaze Patterns ◽

Successful Search ◽

Polyp Detection Rate ◽

Adenoma Detection ◽

Important Quality ◽

Visual Gaze

Abstract Background The adenoma detection rate (ADR) is an important quality indicator in colonoscopy. The aim of this study was to evaluate the changes in visual gaze patterns (VGPs) with increasing polyp detection rate (PDR), a surrogate marker of ADR. Methods 18 endoscopists participated in the study. VGPs were measured using eye-tracking technology during the withdrawal phase of colonoscopy. VGPs were characterized using two analyses – screen and anatomy. Eye-tracking parameters were used to characterize performance, which was further substantiated using hidden Markov model (HMM) analysis. Results Subjects with higher PDRs spent more time viewing the outer ring of the 3 × 3 grid for both analyses (screen-based: r = 0.56, P = 0.02; anatomy: r = 0.62, P < 0.01). Fixation distribution to the “bottom U” of the screen in screen-based analysis was positively correlated with PDR (r = 0.62, P = 0.01). HMM demarcated the VGPs into three PDR groups. Conclusion This study defined distinct VGPs that are associated with expert behavior. These data may allow introduction of visual gaze training within structured training programs, and have implications for adoption in higher-level assessment.

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1302 Ratio of Adenoma Detection Rate to Polyp Detection Rate

British Journal of Surgery ◽

10.1093/bjs/znab259.141 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

S Rajain ◽

A Adam ◽

T Amarnath

Keyword(s):

Colorectal Cancer ◽

Detection Rate ◽

Adenoma Detection Rate ◽

Care Hospital ◽

Polyp Detection ◽

Polyp Detection Rate ◽

Adenoma Detection ◽

Primary Care Hospital ◽

Minimal Rate ◽

The Uk

Abstract Introduction Colorectal cancer is the 3rd most common cancer in the UK. The higher Adenoma Detection Rate during colonoscopy is associated with reduction in the mortality incidence of colorectal cancer. Endoscopists with less than 20% ADR is directly proportional to higher risk of the development of an interval Colorectal cancer. The aim of this study was to calculate the Adenoma Detection Rate and Polyp Detection Rate for each endoscopist to assess the performance of the unit as well as individuals. Method A retrospective analysis was conducted for patients who had colonoscopy in a period of 3 consecutive months at a primary care hospital in England. This study included collecting the data through patient’s histology reports and medical records. The primary outcome was total Adenoma Detection Rate and Polyp Detection Rate and its ratio for each endoscopist. Results 913 colonoscopies were done by 16 different endoscopists out of which 279 patients with polyps were considered for the study. It was observed that half of the total endoscopists were found to have ADR more than 20%. 4 endoscopists had ADR between 15-20% whereas below minimal rate (less than 15%) ADR was recorded by the other 4 endoscopists. Conclusions Lower ADRs are associated with higher rates of interval cancers. An improvement of the ADR of 1% prevents 3% people from colon cancer which can be achieved by maintaining the aspirational adenoma detection rate more than 20%.

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Relationship between the polyp detection rate and the post-colonoscopy colorectal cancer rate

Revista Española de Enfermedades Digestivas ◽

10.17235/reed.2019.5889/2018 ◽

2019 ◽

Vol 111 ◽

Author(s):

Violeta María Sastre Lozano ◽

Senador Morán Sánchez ◽

José García Solano ◽

Pablo Conesa Zamora ◽

Guadalupe Ruiz Merino

Keyword(s):

Colorectal Cancer ◽

Detection Rate ◽

Polyp Detection ◽

Cancer Rate ◽

Polyp Detection Rate

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Recent information on nutritive values of maize silage and its importance in beef cattle feeding

Veterinarski glasnik ◽

10.2298/vetgl0304113j ◽

2003 ◽

Vol 57 (3-4) ◽

pp. 113-124

Author(s):

Rade Jovanovic ◽

Predrag Jovin ◽

Milica Radosavljevic ◽

Snezana Jovanovic ◽

Dusanka Terzic

Keyword(s):

Beef Cattle ◽

Quality Parameters ◽

Quality Parameter ◽

Maize Plant ◽

Silage Maize ◽

Cattle Feeding ◽

Economic Production ◽

Nutritive Values ◽

Important Quality

The study presents the latest scientific accomplishments in selection of silage hybrids with a special regard to digestibility as a quality parameter of the maize plant. The most important quality parameters, necessary in silage maize hybrid selection with the aim of completely defining their nutritive values, are presented in the case of the most demanded MRI hybrids of all maturity groups and encompass the following: the whole plant DM yield, the share of ears in DM yield, NDF, ADF and ADL content, and especially in vitro DM digestibility according to the Tilley and Terry method. Hybrids can be compared by the use of the exact values for the stated criteria and at the same time it is possible to make actual recommendations for certain production. The importance of the whole maize plant silage is manifested in beef cattle feeding, as the use of 3-12 kg silage day-1 with the appropriate feed concentrate significantly contributes to the more economic production of beef for which the demand in our country is realistic.

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Expert endoscopists with high adenoma detection rates frequently detect diminutive adenomas in proximal colon

Endoscopy International Open ◽

10.1055/a-1136-9971 ◽

2020 ◽

Vol 08 (06) ◽

pp. E775-E782

Author(s):

Osamu Toyoshima ◽

Toshihiro Nishizawa ◽

Shuntaro Yoshida ◽

Kazuma Sekiba ◽

Yosuke Kataoka ◽

...

Keyword(s):

Colorectal Cancer ◽

High Risk ◽

Detection Rate ◽

Patient Characteristics ◽

Proximal Colon ◽

Polyp Detection ◽

Detection Rates ◽

Serrated Polyps ◽

Adenoma Detection ◽

Important Quality

Abstract Background and study aims Adenoma detection rate (ADR) is an important quality indicator in colonoscopy, and improved ADR decreases the incidence of colorectal cancer. We investigated differences in polyp detection according to the endoscopist’s ADR. Patients and methods We performed a propensity-score matching study using baseline patient characteristics of age, sex, body mass index, family history of colorectal cancer, smoking, drinking, indication for colonoscopy, bowel preparation, and colonoscope type. We compared polyp detection and colonoscopy procedures between patients who underwent colonoscopy by high-ADR endoscopists (high ADR group) and by low-ADR endoscopists (low ADR group). Results We matched 334 patients in the high ADR group with 334 in the low ADR group. The ADR was 44.0 % and 26.9 % for the high-ADR and low-ADR endoscopists, respectively. Proximal, nonprotruding, and diminutive adenomas were more frequently detected by high-ADR endoscopists than by low-ADR endoscopists (all P < 0.001); similarly, more high-risk adenomas were detected by high-ADR endoscopists (P = 0.028). Furthermore, more sessile serrated polyps detected by high-ADR endoscopists (P = 0.041). High-ADR endoscopists more frequently performed pancolonic chromoendoscopy (P < 0.001). Conclusions Expert detectors often found nonprotruding and diminutive adenomas in the proximal colon along with increased detection rate of high-risk adenomas. Low-ADR endoscopists need to recognize the features of missed adenomas to improve their ADRs.

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