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Polyp Detection Rate Correlates Strongly with Adenoma Detection Rate in Trainee Endoscopists

Abstract

Background

The adenoma detection rate (ADR) is a widely accepted quality benchmark for screening colonoscopy but can be burdensome to calculate. Previous studies have shown good correlation between polyp detection rate (PDR) and ADR, but this has not been validated in trainees. Additionally, the correlation between PDR and detection rates for sessile serrated polyps (SSPDR) and advanced neoplasia (ANDR) is not well studied.

Aims

We investigated the relationship between PDR and ADR, SSPDR, and ANDR in trainees.

Methods

We examined 1600 outpatient colonoscopies performed by 24 trainees at a VA hospital from 2014 to 2017. Variables collected included patient demographics, year of fellowship, colonoscopy indication, and endoscopic and histologic findings. We calculated the overall ratios of PDR to ADR, SSPDR, and ANDR to assess the correlation between measured and calculated ADR, SSPDR, and ANDR, which is equivalent to the correlation between PDR and measured ADR, SSPDR, and ANDR.

Results

The overall PDR, ADR, SSPDR, and ANDR were 72%, 52%, 2%, and 14%. PDR (48%) was highest in the left colon, while ADR (32%) and ANDR (7%) were highest in the right colon (p < 0.001 for all). The overall ADR/PDR, SSPDR/PDR, and ANDR/PDR ratios were 0.73, 0.03, and 0.20. Correlation between PDR and ADR was highly positive overall (r = 0.87, p < 0.0001) and stronger in the right (r = 0.91) and transverse (r = 0.94) colon than the left colon (r = 0.80). Correlation between PDR and overall SSPDR and ANDR were not statistically significant.

Conclusions

PDR can serve as a surrogate measure of ADR to monitor colonoscopy quality in gastroenterology fellowship.

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Funding

Peter S. Liang is supported by Grant K08CA230162 from the National Cancer Institute.

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Contributions

SN: study design, data collection and interpretation, drafted and approved manuscript; AKS: study design, data collection and interpretation, approved manuscript; JP: study design, data collection, approved manuscript; PSL: study design, data collection and interpretation, drafted and approved manuscript.

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Correspondence to Peter S. Liang.

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The authors declare that they have no conflicts of interest.

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Ng, S., Sreenivasan, A.K., Pecoriello, J. et al. Polyp Detection Rate Correlates Strongly with Adenoma Detection Rate in Trainee Endoscopists. Dig Dis Sci 65, 2229–2233 (2020). https://doi.org/10.1007/s10620-020-06049-0

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Keywords

  • Colorectal cancer screening
  • Quality metric
  • Quality improvement
  • Gastroenterology fellow