scholarly journals Screening colonoscopy in Port Harcourt, Nigeria

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Emeka Ray-Offor ◽  
Fatimah B. Abdulkareem
Keyword(s):  
Colorectal Cancer ◽  
Detection Rate ◽  
Screening Colonoscopy ◽  
Low Grade ◽  
Screening And Surveillance ◽  
Port Harcourt ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Low Middle Income Countries ◽  
Low Grade Dysplasia

Colonoscopy is a screening tool for colorectal cancer. The cost of this service, ready availability and expertise are factors limiting its routine use in low-/middle-income countries. The aim was to study premalignant colonic polyps in asymptomatic middle-aged Nigerians and highlight the usefulness of screening colonoscopy in a sub-Saharan African population. We carried out an observational study on asymptomatic patients undergoing screening colonoscopy in a referral endoscopy facility in Port Harcourt, Rivers State, Nigeria from January to December 2018. The variables collated were demographics, endoscopic and histologic findings. Statistical analysis was done using IBM SPSS Statistics for Windows, version 20 Armonk, NY. A total of 144 colonoscopy procedures were performed during the study period with 70 asymptomatic cases for screening indication. Sixty-five were males and 5 females. The age range was from 48 years to 60 years; mean 54.8 ± 3.6 years. A polyp-detection rate of 53.7% was recorded with multiple polyps seen in 13 cases. Adenoma(s) detected in 19 persons were: 22 tubular adenomas with low grade dysplasia; 3 tubulo-villous adenomas with low grade dysplasia; 1 sessile serrated adenoma. The adenoma detection rate was 28.8%. No abnormality was detected in 19 cases. There is a worrisome prevalence of adenomatous polyps; villous adenoma is rare. A targeted policy of screening and surveillance by colonoscopy will curb the rising incidence of colorectal cancer.

scholarly journals 1302 Ratio of Adenoma Detection Rate to Polyp Detection Rate

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%.

scholarly journals Efficacy and Patient Tolerability Profiles of Probiotic Solution with Bisacodyl Versus Conventional Cleansing Solution for Bowel Preparation: A Prospective, Randomized, Controlled Trial

2020 ◽  
Vol 9 (10) ◽  
pp. 3286
Author(s):  
Youn I Choi ◽  
Jong-Joon Lee ◽  
Jun-Won Chung ◽  
Kyoung Oh Kim ◽  
Yoon Jae Kim ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Detection Rate ◽  
Controlled Trial ◽  
Screening Colonoscopy ◽  
Control Group ◽  
Case Group ◽  
Detection Rates ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Bowel Cleansing

Although adequate bowel preparation is essential in screening colonoscopy, patient intolerability to bowel cleansing agents is problematic. Recently, a probiotic mixture solution with bisacodyl emerged to improve patient tolerability. We investigated the efficacy, safety, and patient tolerability profiles of probiotics with bisacodyl versus conventional polyethylene glycol (PEG) solution for bowel preparation for screening colonoscopies in healthy patients in this prospective, randomized, case-control study. In total, 385 volunteers were randomly assigned to receive 2 L of water + 200 mL of probiotic solution (case group, n = 195) or 4 L of PEG solution (control group, n = 190). The efficacy of the bowel cleansing was evaluated using the Ottawa scale system, polyp detection rate, and adenoma detection rate, and the patient tolerability profiles were assessed using a questionnaire. The demographics were not significantly different between groups. When the Ottawa score for each bowel segment was stratified into an adequate vs. inadequate level (Ottawa score ≤ 3 vs. >3), there were no statistical differences between groups in each segment of the colon. There were no significant differences in the polyp and adenoma detection rates between groups (38.42% vs. 32.42, p = 0.30; 25.79% vs. 18.97%, p = 0.11). The case group showed significantly fewer events than the control group, especially nausea, vomiting, and abdominal bloating events. Regarding the overall satisfaction grade, the case group reported significantly more “average” scores (95% vs. 44%, p < 0.001) and were more willing to use the same agents again (90.26% vs. 61.85%, p < 0.001). As patient compliance with bowel preparation agents is associated with an adequate level of bowel cleansing, a probiotic solution with bisacodyl might be a new bowel preparation candidate, especially in patients who show a poor compliance with conventional bowel preparation agents.

scholarly journals PROXIMAL SERRATED POLYP DETECTION RATE: A COMPLEMENTARY QUALITY INDICATOR FOR ADENOMA DETECTION RATE?

2020 ◽  
Vol 57 (4) ◽  
pp. 466-470
Author(s):  
Fernando Antônio Vieira LEITE ◽  
Luiz Cláudio Miranda ROCHA ◽  
Rodrigo Roda Rodrigues SILVA ◽  
Eduardo Garcia VILELA ◽  
Luiz Ronaldo ALBERTI ◽  
...  
Keyword(s):  
Quality Indicator ◽  
Detection Rate ◽  
Adenoma Detection Rate ◽  
Screening Colonoscopy ◽  
Polyp Detection ◽  
Historical Cohort ◽  
Serrated Polyp ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Significant Difference

ABSTRACT BACKGROUND: The effectiveness of colonoscopy for colorectal cancer (CRC) screening depends on quality indicators, which adenoma detection rate (ADR) being the most important. Proximal serrated polyp detection rate (pSPDR) has been studied as a potential quality indicator for colonoscopy. OBJECTIVE: The aim is to analyze and compare the difference in ADR and pSPDR between patients undergoing screening colonoscopy and an unselected population with other indications for colonoscopy, including surveillance and diagnosis. METHODS: This is a historical cohort of patients who underwent colonoscopy in the digestive endoscopy service of a tertiary hospital. Out of 1554 colonoscopies performed, 573 patients were excluded. The remaining 981 patients were divided into two groups: patients undergoing screening colonoscopy (n=428; 43.6%); patients with other indications including surveillance and diagnosis (n=553; 56.4%). RESULTS: Adenoma detection rate of the group with other indications (50.6%) was higher than that of the screening group (44.6%; P=0.03). In regarding pSPDR, there was no difference between pSPDR in both groups (screening 13.6%; other indications 13.7%; P=0.931). There was no significant difference in the mean age (P=0.259) or in the proportion of men and women (P=0.211) between both groups. CONCLUSION: Proximal serrated polyp detection rate showed an insignificant difference between groups with different indications and could be used as a complementary indicator to adenoma detection rate. This could benefit colonoscopists with low colonoscopy volume or low volume of screening colonoscopies.

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

2018 ◽  
Vol 11 ◽  
pp. 117955221881732 ◽  
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.

scholarly journals Colorectal cancer screening program using FIT: quality of colonoscopy varies according to hospital type

2018 ◽  
Vol 06 (09) ◽  
pp. E1149-E1156 ◽  
Author(s):  
Isabel Portillo ◽  
Isabel Idigoras ◽  
Isabel Bilbao ◽  
Eunate Arana-Arri ◽  
María José Fernández-Landa ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Detection Rate ◽  
Screening Colonoscopy ◽  
Hospital Type ◽  
Cecal Intubation ◽  
Academic Hospitals ◽  
Adenoma Detection

Abstract Background and study aims To compare the quality of colonoscopy in a population-based coordinated program of colorectal cancer screening according to type of hospital (academic or non-academic). Patients and methods Consecutive patients undergoing colonoscopy after positive FIT (≥ 20 ug Hb/g feces) between January 2009 and September 2016 were prospectively included at five academic and seven non-academic public hospitals. Screening colonoscopy quality indicators considered were adenoma detection rate, cecal intubation rate, complications and bowel preparation quality. Results A total of 48,759 patients underwent colonoscopy, 34,616 (80 %) in academic hospitals and 14,143 in non-academic hospitals. Among these cases, 19,942 (37.1 %) advanced adenomas and 2,607 (5.3 %) colorectal cancers (CRCs) were detected, representing a total of 22,549 (46.2 %) cases of advanced neoplasia. The adenoma detection rate was 64 %, 63.1 % in academic hospitals and 66.4 % in non-academic hospitals (P < 0.001). Rates of advanced adenoma detection, cecal intubation and adequate colonic preparation were 45.8 %, 96.2 % and 88.3 %, respectively, and in all cases were lower (implying worse quality care) in academic hospitals (45.3 % vs 48.7 %; odds ratio [OR] 0.87, 95 % confidence interval [CI] 0.84 – 0.91; 95.9 % vs 97 %; OR 0.48, 95 % CI 0.38 – 0.69; and 86.4 % vs 93 %; OR 0.48, 95 % CI 0.45 – 0.5; respectively; P < 0.001 in all cases). In 13 patients, all in the academic hospital group, CRC was diagnosed after colonoscopy (0.26 cases × 1000 colonoscopies). Rates of CRC treated by endoscopy were similar in both types of hospital (30 %). The rate of severe complication was 1.2 % (602 patients), with no significant differences by hospital type: bleeding occurred in 1/147 colonoscopies and perforation in 1/329. One patient died within 30 days after screening colonoscopy. Conclusions The quality of colonoscopy was better in non-academic hospitals. The rate of detection of advanced neoplasia was higher in non-academic hospitals and correlated with the rate of post-colonoscopy CRC.

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

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.

Nonneoplastic polypectomy during screening colonoscopy: the impact on polyp detection rate, adenoma detection rate, and overall cost

2015 ◽  
Vol 82 (2) ◽  
pp. 370-375.e1 ◽  
Author(s):  
Mary A. Atia ◽  
Neal C. Patel ◽  
Shiva K. Ratuapli ◽  
Erika S. Boroff ◽  
Michael D. Crowell ◽  
...  
Keyword(s):  
Detection Rate ◽  
Adenoma Detection Rate ◽  
Screening Colonoscopy ◽  
Polyp Detection ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
The Impact
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