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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA A Cancer J Clin. 2019;69:7–34.
Nishihara R, Wu K, Lochhead P, et al. Long-term colorectal-cancer incidence and mortality after lower endoscopy. N Engl J Med. 2013;369:1095–1105.
Kahi CJ, Pohl H, Myers LJ, et al. Colonoscopy and colorectal cancer mortality in the veterans affairs health care system: a case–control study. Ann Intern Med. 2018;168:481–488.
Rex DK, Schoenfeld PS, Cohen J, et al. Quality indicators for colonoscopy. Am J Gastroenterol. 2015;110:72–90.
Corley DA, Jensen CD, Marks AR, et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med. 2014;370:1298–1306.
Wieszczy P, Regula J, Kaminski MF. Adenoma detection rate and risk of colorectal cancer. Best Pract Res Clin Gastroenterol. 2017;31:441–446.
Francis DL, Rodriguez-Correa DT, Buchner A, et al. Application of a conversion factor to estimate the adenoma detection rate from the polyp detection rate. Gastrointest Endosc. 2011;73:493–497.
Boroff ES, Gurudu SR, Hentz JG, et al. Polyp and adenoma detection rates in the proximal and distal colon. Am J Gastroenterol. 2013;108:993–999.
Niv Y. Polyp detection rate may predict adenoma detection rate: a meta-analysis. Eur J Gastroenterol Hepatol. 2018;30:247–251.
Peters SL, Hasan AG, Jacobson NB, et al. Level of fellowship training increases adenoma detection rates. Clin Gastroenterol Hepatol. 2010;8:439–442.
Lee J, Park SW, Kim YS, et al. Risk factors of missed colorectal lesions after colonoscopy. Medicine. 2017;96:e7468.
Okamoto M, Shiratori Y, Yamaji Y, et al. Relationship between age and site of colorectal cancer based on colonoscopy findings. Gastrointest Endosc. 2002;55:548–551.
Lieberman DA, Williams JL, Holub JL, et al. Colonoscopy utilization and outcomes 2000 to 2011. Gastrointest Endosc. 2014;80:133–143.
Sanaka MR, Gohel T, Podugu A, et al. Adenoma and sessile serrated polyp detection rates: variation by patient sex and colonic segment but not specialty of the endoscopist. Dis Colon Rectum. 2014;57:1113–1119.
Kahi CJ, Hewett DG, Norton DL, et al. Prevalence and variable detection of proximal colon serrated polyps during screening colonoscopy. Clin Gastroenterol Hepatol. 2011;9:42–46.
Gohel TD, Burke CA, Lankaala P, et al. Polypectomy rate: a surrogate for adenoma detection rate varies by colon segment, gender, and endoscopist. Clin Gastroenterol Hepatol. 2014;12:1137–1142.
Funding
Peter S. Liang is supported by Grant K08CA230162 from the National Cancer Institute.
Author information
Authors and Affiliations
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.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflicts of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Guarantor of the article: Peter S. Liang.
Rights and permissions
About this article
Cite this article
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
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10620-020-06049-0