scholarly journals The Appropriateness of Surveillance Colonoscopy Intervals after Polypectomy

2013 ◽  
Vol 27 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Eline Schreuders ◽  
Jerome Sint Nicolaas ◽  
Vincent de Jonge ◽  
Harmke van Kooten ◽  
Isaac Soo ◽  
...  
Keyword(s):  
Time Interval ◽  
Surveillance Colonoscopy ◽  
Time Intervals ◽  
Detection Rates ◽  
Median Difference ◽  
Adenoma Detection ◽  
Significant Difference ◽  
Surveillance Interval ◽  
History Of ◽  
Adenoma Detection Rates

BACKGROUND: Adherence to surveillance colonoscopy guidelines is important to prevent colorectal cancer (CRC) and unnecessary workload.OBJECTIVE: To evaluate how well Canadian gastroenterologists adhere to colonoscopy surveillance guidelines after adenoma removal or treatment for CRC.METHODS: Patients with a history of adenomas or CRC who had surveillance performed between October 2008 and October 2010 were retrospectively included. Time intervals between index colonoscopy and surveillance were compared with the 2008 guideline recommendations of the American Gastroenterological Association and regarded as appropriate when the surveillance interval was within six months of the recommended time interval.RESULTS: A total of 265 patients were included (52% men; mean age 58 years). Among patients with a normal index colonoscopy (n=110), 42% received surveillance on time, 38% too early (median difference = 1.2 years too early) and 20% too late (median difference = 1.0 year too late). Among patients with nonadvanced adenomas at index (n=96), 25% underwent surveillance on time, 61% too early (median difference = 1.85) and 14% too late (median difference = 1.1). Among patients with advanced neoplasia at index (n=59), 29% underwent surveillance on time, 34% too early (median difference = 1.86) and 37% later than recommended (median difference = 1.61). No significant difference in adenoma detection rates was observed when too early surveillance versus appropriate surveillance (34% versus 33%; P=0.92) and too late surveillance versus appropriate surveillance (21% versus 33%; P=0.11) were compared.CONCLUSION: Only a minority of surveillance colonoscopies were performed according to guideline recommendations. Deviation from the guidelines did not improve the adenoma detection rate. Interventions aimed at improving adherence to surveillance guidelines are needed.

scholarly journals Comparison of colon adenoma detection rates using cap-assisted and Endocuff-assisted colonoscopy: a randomized controlled trial

2019 ◽  
Vol 07 (12) ◽  
pp. E1585-E1591 ◽  
Author(s):  
Joseph Marsano ◽  
Sheeva Johnson ◽  
Stephanie Yan ◽  
Latifat Alli-Akintade ◽  
Machelle Wilson ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Polyp Size ◽  
Withdrawal Time ◽  
Detection Rates ◽  
Patient Demographics ◽  
Randomized Controlled ◽  
Adenoma Detection ◽  
Significant Difference ◽  
Adenoma Detection Rates

Abstract Objectives and study aim Colonoscopy prevents colorectal cancer by removing adenomatous polyps, but missed adenomas lead to interval cancers. Different devices have been used to increase adenoma detection rates (ADR). Two such devices of interest are the transparent cap (Olympus) and Endocuff (ARC Medical). Our study aimed to compare differences in ADR between Endocuff-assisted colonoscopy (EAC), cap-assisted colonoscopy (CAC) and standard colonoscopy (SC). Patients and methods A sample size of 126 subjects was calculated to determine an effect size of 30 %. Patients undergoing screening or surveillance colonoscopy between March 2016 and January 2017 were randomized to SC, CAC or EAC groups. Three experienced endoscopists performed all colonoscopies. Patient demographics, procedure indication, Boston Bowel Prep Score (BBPS), withdrawal time, polyp size, location, histopathology, were analyzed. Results There was no difference in ADR (52 %, 40 % and 54 %) in the SC, CAC and EAC groups respectively (P = 0.4). Similar findings were also observed for proximal ADR (45 %, 35 %, and 50 %, P = 0.4) and SSA detection rate (16 %, 14 %, and 23 %, P = 0.5). EAC detected higher mean ADR per colonoscopy compared to CAC (1.70 vs 0.76, P = 0.01). However, there was no significant difference in mean ADR per positive colonoscopy (2.08, 1.63, and 2.59, P = 0.21). Conclusion In a randomized controlled trial comparing AC to CAC and SC, neither device conferred additional benefits in ADR among high detectors. When comparing each device, EAC may be better than CAC at detecting more total adenomas.

scholarly journals The Impact of Colonoscopy Quality Control Table on Adenoma Detection Rates

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Bin Deng ◽  
Jiehua Zhi ◽  
Yaosheng Chen ◽  
Lanyu Liang ◽  
Jian Wu ◽  
...  
Keyword(s):  
Success Rate ◽  
Detection Rate ◽  
Intervention Group ◽  
Withdrawal Time ◽  
Detection Rates ◽  
Adenoma Detection ◽  
Significant Difference ◽  
Adenoma Detection Rates ◽  
Colonoscopy Quality ◽  
The Impact

Objective. This study aims to investigate the effects of reporting colonoscopy findings and the regular review of outcomes on adenoma detection rates.Methods. Patients who underwent colonoscopy from August 2013 to February 2014 were selected as the intervention group. The preintervention group included patients who underwent colonoscopy from January 2013 to July 2013, in which the procedure sheet for this group of patients was not accomplished. The primary outcome was adenoma detection rate (ADR), and secondary outcomes included the success rate of intubation and withdrawal time.Results. This study included 2,467 cases: 1,302 cases in the intervention group and 1,165 cases in the preintervention group. There was no significant difference in demographic characteristics between the two groups. In the intervention group, withdrawal time of colonoscopy was longer (P<0.01), and the success rate of intubation (92.5% versus 89.1%,P<0.05) and detection rate of polyps (32.6% versus 27.6%,P<0.05) and adenomas (20.0% versus 16.1%,P<0.05) were higher. Significantly high detection rates for proximal adenomas, flat adenomas, and adenomas with a diameter <5 mm were observed in the intervention group (allP<0.01).Conclusion. The reporting and review of procedure details help to improve quality indicators of colonoscopy.

scholarly journals A78 COMPARISON OF THE NICE, SANO, AND WASP CLASSIFICATIONS FOR OPTICAL DIAGNOSIS OF SMALL COLORECTAL POLYPS

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 92-93
Author(s):  
R Djinbachian ◽  
H Pohl ◽  
E Marchand ◽  
P Marques ◽  
M Bouin ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Colorectal Polyps ◽  
Classification Systems ◽  
Optical Diagnosis ◽  
Polyp Detection ◽  
Detection Rates ◽  
Adenoma Detection ◽  
Multiple Classification ◽  
Surveillance Interval ◽  
Adenoma Detection Rates

Abstract Background Optical diagnosis can be used as an alternative to pathology for the evaluation of colorectal polyps. There exist multiple classification systems that can be used to assist in performing optical diagnosis. Aims The aim of this study was to compare three different optical diagnosis classifications (NICE, SANO and WASP) when using Optivista and iScan image enhanced endoscopy (IEE). Methods The study included subjects between 45–80 years undergoing an elective screening, surveillance, or diagnostic colonoscopy with optical diagnosis using Optivista or iScan IEE. Three validated IEE scales (NICE, SANO and WASP classifications) were used for all optical diagnoses. Primary outcome was the agreement with pathology for surveillance intervals determined when using NICE, SANO and WASP for polyps 1-10mm. Secondary outcomes for polyps 1-10mm included accuracy of polyp diagnosis and negative predictive value (NPV) for rectosigmoid adenomas. Results A total of 399 patients were prospectively enrolled in the trial. The polyp detection and adenoma detection rates were 58.6% and 38.8% respectively. The proportion of correct surveillance interval assignment when at least one optical diagnosis was made was 92.9% when using NICE, 92.3% when using SANO, 89.5% when using WASP (p=0.656). Correct diagnosis was made for 74.2% of polyps when using NICE, 74.2% when using SANO, 65.6% when using WASP (p=0.012). The NPV for rectosigmoid adenomas was 91.2% when using NICE, 90.5% when using SANO, 87.5% when using WASP. Conclusions For optical diagnosis using Optivista and iScan IEE, all studied classifications performed equally for surveillance interval assignment. WASP had lower proportion of correct diagnoses on a polyp level and lower NPV for rectosigmoid adenomas. Funding Agencies None

scholarly journals Effect of Colonoscopy Volume on Quality Indicators

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
David Pace ◽  
Mark Borgaonkar ◽  
Muna Lougheed ◽  
Curtis Marcoux ◽  
Brad Evans ◽  
...  
Keyword(s):  
Case Volume ◽  
Detection Rates ◽  
Adenoma Detection ◽  
Confounding Variables ◽  
Significant Difference ◽  
Adenoma Detection Rates ◽  
Multivariable Regression ◽  
Male Sex ◽  
Colonoscopy Quality

Background. The purpose of this study is to determine if colonoscopy quality is associated with the annual case volume of endoscopists.Methods. A retrospective cohort study was performed on 3235 patients who underwent colonoscopy in the city of St. John’s, NL, between January and June 2012. Data collected included completion of colonoscopy (CCR) and adenoma detection rates (ADR). Endoscopists were divided into quintiles based on annual case volume. To account for potential confounding variables, univariate analyses followed by multivariable logistic regression were used to identify variables independently associated with CCR and ADR.Results. A total of 13 surgeons and 8 gastroenterologists were studied. There was a significant difference in CCR (p< 0.001) and ADR (p< 0.001) based on annual volume. Following multivariable regression, predictors of successful colonoscopy completion included annual colonoscopy volume, lower age, male sex, an indication of screening or surveillance, and a low ASA score. Predictors of adenoma detection included older age, male sex, an indication of screening or surveillance, and gastroenterology specialty.Conclusion. Higher annual case volume is associated with better quality of colonoscopy in terms of completion. However, gastroenterology specialty appears to be a better predictor of ADR than annual case volume.

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