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

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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S291 Sessile Serrated Polyp Detection Rate of 2% or Greater Is Associated With a Lower Risk for Post-Colonoscopy Colorectal Cancer

The American Journal of Gastroenterology ◽

10.14309/01.ajg.0000773636.07396.36 ◽

2021 ◽

Vol 116 (1) ◽

pp. S128-S128

Author(s):

Joseph Anderson ◽

William Hisey ◽

Todd Mackenzie ◽

Christina Robinson ◽

Lynn Butterly

Keyword(s):

Colorectal Cancer ◽

Lower Risk ◽

Detection Rate ◽

Polyp Detection ◽

Serrated Polyp ◽

Polyp Detection Rate

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Correlation between number of polyps detected per colonoscopy and polyp detection rate in average risk Chinese population of colorectal cancer

World Chinese Journal of Digestology ◽

10.11569/wcjd.v23.i16.2647 ◽

2015 ◽

Vol 23 (16) ◽

pp. 2647

Author(s):

Zi-Ye Zhao

Keyword(s):

Colorectal Cancer ◽

Chinese Population ◽

Detection Rate ◽

Average Risk ◽

Polyp Detection ◽

Polyp Detection Rate

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Melanosis Coli: A Helpful Contrast Effect or a Harmful Pigmentation?

Clinical Medicine Insights Gastroenterology ◽

10.1177/1179552218817321 ◽

2018 ◽

Vol 11 ◽

pp. 117955221881732 ◽

Cited By ~ 1

Author(s):

Fadi Abu Baker ◽

Amir Mari ◽

Dan Feldman ◽

Muhammad Suki ◽

Oren Gal ◽

...

Keyword(s):

Colorectal Cancer ◽

Detection Rate ◽

Control Group ◽

P Value ◽

Polyp Detection ◽

Detection Rates ◽

Benign Condition ◽

Melanosis Coli ◽

Polyp Detection Rate ◽

Adenoma Detection

Background: Melanosis coli, a brown discoloration of colonic mucosa, is considered as a benign condition mainly observed in patients under chronic anthranoid laxatives. Recent data link this condition with an increased adenoma detection rate. Moreover, its tumorigenic potential and possible association with the development of colorectal cancer remains uncertain. We conducted this study to compare the polyp detection rate and colorectal cancer diagnosis in patients with melanosis against matched control group without melanosis. Patients and methods: A retrospective single-center study. Patients diagnosed with melanosis coli on colonoscopy over a 15-year period were included. Each melanosis coli patient was matched with three controls by age, gender, setting (inpatient/outpatient), and procedure’s indication. Polyp detection rate and diagnosis of colorectal cancer were recorded and compared between the groups before and after adjustment for bowel preparation. Results: A cohort of 718 patients with melanosis and 2154 controls were included. The polyp detection rates were 33.4% and 21.8% of melanosis and control groups, respectively ( P < .001). Melanosis coli, however, was associated with less diagnosis of colorectal cancer than controls (0.3% vs 3.9%; P < .001). In multivariate analysis, melanosis diagnosis on endoscopy was significantly associated with higher polyp detection rate (odds ratio [OR] = 1.986, 95% confidence interval [CI]: 1.626-2.425; P value < .01). Conclusions: Melanosis coli is not associated with increased diagnosis of colorectal cancer. It is associated, however, with enhanced polyp detection likely due to chromo-endoscopy-like effect.

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Effect of Screen Distance on Colonic Polyp Detection and Colonic Polyp Size Estimation: A Pilot Study

Medical Research Archives ◽

10.18103/mra.v9i8.2483 ◽

2021 ◽

Vol 9 (8) ◽

Author(s):

Saqib Walayat ◽

Abuzar Asif ◽

Muhammad Baig ◽

Srinivas Puli ◽

Daniel Martin

Keyword(s):

Colorectal Cancer ◽

Detection Rate ◽

Colonic Mucosa ◽

Colonic Polyp ◽

Normal Colonic Mucosa ◽

Size Estimation ◽

Polyp Detection ◽

Polyp Size ◽

Polyp Detection Rate ◽

Adenoma Detection

Background Colorectal cancer is the 3rd most common cancer in the world, with about 1.2 million new cases reported annually. It is one of the three most common causes of cancer related mortality in Europe and North America. Thus, prevention and detection are critical aspects in managing colorectal cancer. Colonoscopy remains the gold standard for screening of colorectal cancer, as it is valuable not only for detection but also prevention with polyp identification. Adenoma detection rate remains a pivotal part of a good endoscopic exam. While various factors have been known to influence it, data regarding ideal screen distance for adenoma detection remains unclear. The aim of this study was to assess the rate of polyp detection and estimate the size of diminutive (<1 cm) polyps with varying screen distance from the proceduralist. Materials and Methods This was a quality improvement project carried at OSF Saint Francis Medical center where post graduate trainees and attending physicians were enrolled. A 26-inch-high resolution screen was used and placed at eye level for the endoscopist. We selected 50 high resolution slides of polyps (<1 cm) intermixed with slides of normal colonic mucosa. These slides were downloaded from Orpheus Medical, a global clinical media platform and video informatics company. These were shown to each endoscopist standing either 3, 6, or 9 feet away (0.91, 1.8, or 2.7 meters) from the screen on three separate days, arranged in 3 different configurations. Both the rate of polyp detection and the sizes of polyps measured at various distances were recorded. The endoscopists were able to move +/- 10 cm (0.5 feet) from their index position to enhance their visualization and for better accommodation. The data was collected for multiple outcomes and statistical analysis was performed using odds ratio and t-test. Results Seven subjects who were either 3rd year Gastroenterology fellows or attendings were included in the study. We included 50 slides, with 33 consisting of polyps (<1 cm) and others containing normal colonic mucosa. Our results showed that the number of polyps detected decreased as the distance from the screen increased. Overall polyp detection rate (PDR) was 92.18% at 3 feet (0.91 m), 87% at 6 feet (1.8m) and 77% at 9 feet (2.7m). An endoscopist positioned at 3 ft had a statistically significant higher polyp detection rate than one positioned at 9 ft with odds ratio (OR) of 3.43 (95% CI: 1.45 – 8.11, p= 0.004). The mean polyp size reported by all subjects was 2.68 mm at 3 feet, 2.57 mm at 6 feet and 2.25 mm at 9 feet. Comparison of mean polyp sizes at different distances from screen did not reveal statistically significant differences. Secondary outcomes included accuracy of polyp detection, miss rate and mean overestimation rate. The participating subjects were surveyed verbally at the end of the study to assess their comfort at various distances. They reported the highest level of comfort at 3 feet (0.91m), followed by 6 feet (1.8m). Conclusions This quality improvement study sheds light on the importance of screen distance for polyp detection, especially in case of smaller polyps <1cm. Our results show that ideal screen distance for polyp detection should be close to 3 feet (0.91m) and ideally no more than 6 feet (1.8m). Similarly, our results also point out that polyp size may be overestimated if the examiner is too close to the screen and underestimated if the examiner is too far from the screen. We advocate standardization of screen distance from the endoscopist, so that the polyp size estimation is uniform across the board.

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Colorectal Cancer and Polyps in Diverticulosis Patients: A 10-Year Retrospective Study in 13680 Patients

Gastroenterology Research and Practice ◽

10.1155/2019/2507848 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Fadi Abu Baker ◽

Jesus Alonso Z'cruz De La Garza ◽

Amir Mari ◽

Abdel-Rauf Zeina ◽

Amani Bishara ◽

...

Keyword(s):

Colorectal Cancer ◽

Detection Rate ◽

Colonic Polyps ◽

Control Group ◽

Polyp Detection ◽

Detection Rates ◽

Screening And Surveillance ◽

Polyp Detection Rate ◽

Increased Risk ◽

Diagnosis Rate

Introduction. Shared by certain epidemiological and etiological characteristics, diverticulosis and colorectal cancer (CRC) as well as colonic polyps has long been linked. This association was studied in several heterogeneous studies but has reported inconsistent results. Clarifying the association is clinically relevant for endoscopist awareness and potential modification of screening and surveillance intervals for diverticulosis patients. Methods. In this retrospective single-center study, patients diagnosed with diverticulosis on colonoscopy over a 10-year period were included. Each diverticulosis patient was matched with 1 control by age, gender, setting (inpatient/outpatient), and procedure’s indication. CRC and polyp detection rates were recorded and compared between the groups before and after adjustment for bowel preparation quality and exam completion. CRC location was recorded and compared between groups. Results. A cohort of 13680 patients (6840 patients with diverticulosis and 6840 matched controls) was included. Diverticulosis was located mainly to the sigmoid and left colon (94.4%). The CRC diagnosis rate was lower in the diverticulosis group (2% vs. 4.5%, odds ratio=0.472, P<0.001, and 95%CI=0.382‐0.584). Moreover, location of CRC was unrelated to diverticulosis location, as more CRCs in the diverticulosis group were located proximal to the splenic flexure as compared to the control group (42.5% vs 29.5%, respectively; P=0.007). Diverticulosis, however, was associated with an increased polyp detection rate compared to controls (30.5% vs. 25.5%; odds ratio=1.2, P<0.001, and 95%CI=1.11‐1.299). Conclusion. We demonstrated that diverticulosis was not associated with an increased risk for CRC. A possible increased polyp detection rate, however, warrants further evaluation in large prospective studies.

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CONVERSION FACTOR FOR PREDICTING ADENOMA DETECTION RATE FROM POLYP DETECTION RATE VARY ACCORDING TO COLONOSCOPY INDICATION AND GENDER OF ENDOSCOPED INDIVIDUALS

10.1055/s-0038-1637214 ◽

2018 ◽

Author(s):

G Vojtechova ◽

S Suchanek ◽

O Ngo ◽

B Buckova ◽

T Grega ◽

...

Keyword(s):

Detection Rate ◽

Conversion Factor ◽

Adenoma Detection Rate ◽

Polyp Detection ◽

Polyp Detection Rate ◽

Adenoma Detection ◽

And Gender

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A117 PROPOFOL SEDATION DOES NOT IMPROVE MEASURES OF COLONOSCOPY QUALITY – FINDINGS FROM THE SOUTHWEST ONTARIO COLONOSCOPY COHORT

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.115 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 97-98

Author(s):

M Sey ◽

B Yan ◽

Z Hindi ◽

M Brahmania ◽

J C Gregor ◽

...

Keyword(s):

Detection Rate ◽

Conscious Sedation ◽

Intubation Rate ◽

Polyp Detection ◽

Cecal Intubation ◽

Propofol Sedation ◽

Serrated Polyp ◽

Polyp Detection Rate ◽

Cecal Intubation Rate ◽

Colonoscopy Quality

Abstract Background The use of propofol during colonoscopy has gained increased popularity due to deeper anesthesia compared to conscious sedation. Prior studies examining the use of propofol sedation during colonoscopy have primarily focused on anesthesia outcomes. Whether propofol sedation is associated with improvements in colonoscopy outcomes is uncertain. Aims The primary outcome was adenoma detection rate (ADR). Secondary outcomes were the detection of any adenoma (conventional adenoma, sessile serrated polyp, and traditional serrated adenoma), sessile serrated polyp detection rate, polyp detection rate, cecal intubation rate, and perforation rate. Methods The Southwest Ontario Colonoscopy cohort consists of all patients who underwent colonoscopy between April 2017 and Oct 2018 at 21 hospitals serving a large geographic area in Southwest Ontario. Procedures performed in patients less than 18 years of age or by endoscopist who perform <50 colonoscopies/year were excluded. Data were collected through a mandatory quality assurance form that was completed by the endoscopist after each procedure. Pathology reports were manually reviewed. Results A total of 46,634 colonoscopies were performed by 75 physicians (37.5% by gastroenterologists, 60% by general surgeons, 2.5% others) of which 16,408 (35.2%) received propofol and 30,226 (64.8%) received conscious sedation (e.g. combination of a benzodiazepine and a narcotic). Patients who received propofol were likely to have a screening indication (49.2% vs 45.5%, p<0.0001), not have a trainee endoscopist present and be performed at a non-academic centre (32.2% vs 44.6%, p<0.0001). Compared to conscious sedation, use of propofol was associated with a lower ADR (24.6% vs. 27.0%, p<0.0001) and detection of any adenoma (27.7% vs. 29.8%, p<0.0001); no difference was observed in the detection ofsessile serrated polyps (5.0% vs. 4.7%, p=0.26), polyp detection rate (41.2% vs 41.2%, p=0.978), cecal intubation rate (97.1% vs. 96.8%, p=0.15) or perforation rate (0.04% vs. 0.06%,p=0.45). On multi-variable analysis, the use of propofol was not significantly associated with any improvement in ADR (RR=0.90, 95% CI 0.74–1.10, p=0.30), detection of any adenoma (RR=0.93, 95% CI 0.75–1.14, p=0.47), sessile serrated polyp detection rate (RR=1.20, 95%CI 0.90–1.60, p=0.22), polyp detection rate (RR=1.00, 95% CI 0.90–1.11, p=0.99), or cecal intubation rate (RR=1.00, 95%CI 0.80–1.26, p=0.99). Conclusions The use of propofol sedation does not improve colonoscopy quality metrics. Funding Agencies None

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