Surgical Endoscopy

, Volume 32, Issue 3, pp 1141–1148 | Cite as

Can polyp detection rate be used prospectively as a marker of adenoma detection rate?

  • Brent Murchie
  • Kanwarpreet Tandon
  • Shamiq Zackria
  • Steven D. Wexner
  • Colin O’Rourke
  • Fernando J. Castro



Adenoma detection rate (ADR) is a quality indicator for screening colonoscopy, but its calculation is time-consuming. Polyp detection rate (PDR) has been found to correlate with ADR; however, its use as a quality indicator has been criticized out of concern for endoscopists artificially inflating the PDR. We aim to evaluate whether active monitoring affects PDR.


In March 2015, 14 endoscopists were made aware that their personal PDRs would be tracked monthly as a quality improvement project. Endoscopists received a report of their individual monthly and cumulative PDR, departmental averages, and a benchmark PDR. Following the intervention, data were collected for consecutive patients undergoing average risk screening colonoscopy for six months. PDR, ADR, and adenoma to polyp detection ratio quotient (APDRQ) were compared to a six-month pre-intervention period.


2203 patients were included in the study. There was no statistically significant difference in PDR when comparing pre- and post-intervention (44 vs. 45%, OR 1.04; 95% CI 0.77–1.36). No statistically significant difference in ADR was observed when comparing pre- and post-intervention (29 vs. 30%, OR 1.03; 95% CI 0.64–1.52). There was no statistically significant difference in APDRQ when comparing pre- and post-intervention (0.67 vs. 0.66, OR 0.99; 95% CI 0.69–1.33).


Monthly report cards did not result in a change in PDR or APDRQ. In some environments, PDR can be used as a surrogate marker of ADR, despite endoscopist awareness that PDR is being measured.


Colorectal adenoma Polyp detection rate Adenoma detection rate 


Compliance with ethical standards


Brent Murchie, Kanwarpreet Tandon, Shamiq Zackria, Steven D. Wexner, Colin O’Rourke and Fernando J. Castro has no conflict of interest or financial ties to disclose.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Brent Murchie
    • 1
  • Kanwarpreet Tandon
    • 2
  • Shamiq Zackria
    • 3
  • Steven D. Wexner
    • 1
  • Colin O’Rourke
    • 4
  • Fernando J. Castro
    • 1
  1. 1.Department of Gastroenterology, Digestive Diseases InstituteCleveland Clinic FloridaWestonUSA
  2. 2.Department of Internal MedicineBlake Medical CenterBradentonUSA
  3. 3.Department of Internal MedicineAultman HospitalCantonUSA
  4. 4.Quantitative Health SciencesCleveland ClinicClevelandUSA

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