Surveying ADR knowledge and practices   among US gastroenterologists

Background: The adenoma detection rate (ADR) is of primary importance to the quality of screening colonoscopy. An online survey was conducted to assess knowledge and practices on ADR. Methods: Paid questionnaire distributed by email. Eligible respondents were board certified gastroenterologists who perform >80 colonoscopies per month with 3 to 35 years after fellowship. Results: 39% were unaware that ADR applies only to screening colonoscopies and 76% incorrectly answered that ADR includes sessile serrated polyps/adenomas. 51% of respondents incorrectly believe the threshold is set at 25% because 25% is a national ADR average. Many also believe the threshold depends on the patient population (current evidence suggests adjusting ADR for factors other than age and sex is unnecessary). 75% ranked ADR as highly important. 80% reported tracking ADR. A busy practice was the most common reason for not tracking ADR. Caps, chromoendoscopy, and good bowel preparation were viewed as valuable for improving ADR (this is true except for caps). HD colonoscopes and education were considered less valuable (although evidence suggests HD and education are associated with improved ADR). 57% reported not sharing ADR information with their patients, and 59% reported no patients in the past 6 months asking for their ADR. Conclusion: The importance of ADR as a validated quality measure is well understood, but there are misconceptions among gastroenterologists regarding the definition and measurement of ADR and which methods are proven to increase ADR. Patients are having very little impact on ADR measurement.

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Impact of Video Aid on Quality of Bowel Preparation Among Patients Undergoing Outpatient Screening Colonoscopy

Clinical Medicine Insights Gastroenterology ◽

10.1177/1179552218803304 ◽

2018 ◽

Vol 11 ◽

pp. 117955221880330

Author(s):

Sanna Fatima ◽

Deepanshu Jain ◽

Christopher Hibbard

Keyword(s):

Bowel Preparation ◽

Detection Rate ◽

Adenoma Detection Rate ◽

Screening Colonoscopy ◽

Advanced Adenoma ◽

Control Group ◽

P Value ◽

Group I ◽

Adenoma Detection

Aim: To investigate the effect of video aid on quality of bowel preparation. Study: A retrospective study was done on patients undergoing outpatient screening colonoscopy. All subjects received educational video prior to colonoscopy in addition to the standard counseling. Patient charts were reviewed to collect data regarding quality of bowel preparation (adequate or inadequate). The study population was stratified into four groups according to viewing status: Group I 0% (control group), Group II <50%, Group III >50% to <75%, and Group IV watched ⩾75% of the video. Results: A total of 338 patients with an average age of 59.1 years and 60.3% females were included in the final study cohort. Of the patients in Groups I, II, III, and IV, 94.3%, 90.9%, 100%, and 91.7%, respectively, had adequate preparation ( P value = .827). Adenoma detection rate (ADR) for Groups I, II, III, and IV was 28.8%, 50%, 50%, and 22.6%, respectively ( P value = .305). The mean cecal intubation time was 20.7, 16.4, 16.57, and 17 minutes for Groups I, II, III, and IV, respectively ( P value = .041). Conclusions: Video aid use for patients undergoing screening colonoscopy lacked a statistically significant impact on the quality of bowel preparation, ADR, and advanced adenoma detection rate when compared with standard practice.

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Tu1507 Prospective Randomized Controlled Trial to Study the Effect of Multimedia Education Before Screening Colonoscopy on Quality of Bowel Preparation and Adenoma Detection Rate

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2014.02.953 ◽

2014 ◽

Vol 79 (5) ◽

pp. AB565-AB566

Author(s):

Shashank Garg ◽

Mohit Girotra ◽

Sumanjit Kaur ◽

Allawy Allawy ◽

Sudhir Dutta

Keyword(s):

Randomized Controlled Trial ◽

Bowel Preparation ◽

Detection Rate ◽

Controlled Trial ◽

Screening Colonoscopy ◽

Randomized Controlled ◽

Multimedia Education ◽

Adenoma Detection ◽

Prospective Randomized Controlled Trial

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Serrated lesions of the colon and rectum: Emergent epidemiological data and molecular pathways

Open Medicine ◽

10.1515/med-2020-0226 ◽

2020 ◽

Vol 15 (1) ◽

pp. 1087-1095

Author(s):

Michele Sacco ◽

Fatima Domenica Elisa De Palma ◽

Elia Guadagno ◽

Mariano Cesare Giglio ◽

Roberto Peltrini ◽

...

Keyword(s):

Malignant Transformation ◽

Detection Rate ◽

Epidemiological Data ◽

Screening Colonoscopy ◽

Current Evidence ◽

Surveillance Program ◽

Cancer Risk Factors ◽

Serrated Polyps ◽

Serrated Lesions ◽

Molecular Aspects

AbstractIn 2010, serrated polyps (SP) of the colon have been included in the WHO classification of digestive tumors. Since then a large corpus of evidence focusing on these lesions are available in the literature. This review aims to analyze the present data on the epidemiological and molecular aspects of SP. Hyperplastic polyps (HPs) are the most common subtype of SP (70–90%), with a minimal or null risk of malignant transformation, contrarily to sessile serrated lesions (SSLs) and traditional serrated adenomas (TSAs), which represent 10–20% and 1% of adenomas, respectively. The malignant transformation, when occurs, is supported by a specific genetic pathway, known as the serrated-neoplasia pathway. The time needed for malignant transformation is not known, but it may occur rapidly in some lesions. Current evidence suggests that a detection rate of SP ≥15% should be expected in a population undergoing screening colonoscopy. There are no differences between primary colonoscopies and those carried out after positive occult fecal blood tests, as this screening test fails to identify SP, which rarely bleed. Genetic similarities between SP and interval cancers suggest that these cancers could arise from missed SP. Hence, the detection rate of serrated-lesions should be evaluated as a quality indicator of colonoscopy. There is a lack of high-quality longitudinal studies analyzing the long-term risk of developing colorectal cancer (CRC), as well as the cancer risk factors and molecular tissue biomarkers. Further studies are needed to define an evidence-based surveillance program after the removal of SP, which is currently suggested based on experts’ opinions.

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