Assessment of quality benchmarks in adenoma detection in Mexico

Abstract

Background and study aims Several Latin American countries, including Mexico, have reported an increase in colorectal cancer (CRC) mortality. The effectiveness of a colonoscopy in preventing CRC depends on the quality of the procedure, for which the adenoma detection rate (ADR) is one of the most trusted indicators. Awareness of ADR can improve the quality of colonoscopies through proper feedback and training of the specialists. The goal of this study was to estimate the ADR among Mexican endoscopists with experience in CRC screening and to compare it with previously reported data from this country. Methods We carried out a retrospective study to analyze ADR data in Mexico. The information was obtained from a group of certified endoscopists and compared with the former published data from Mexico. Results We found a current ADR of 24.6 % (95 %CI, 22.4 %–26.8 %) from 1,478 colonoscopies performed by eight endoscopists in two third-level private hospitals. The average ADR reported in previous publications was 15.2 % (95 %CI, 13.3 %–17.1 %). Statistical analysis showed differences between our results and those from previous studies (24.6 % vs. 15.2 %, P < 0.001). Conclusions The actual ADR in Mexico is higher than previously reported. Previous low ADR values could be explained by poorly performed colonoscopies rather than by low adenoma and CRC incidence in our country.

Adenoma detection rate in gastroenterology residents: a retrospective study in a gastroenterology clinic

“…The ADR for the group that involves fellows was 31.5% (95% CI: 26.7-36.2%), while the attendings alone had 30.4% (95% CI: 26.9-33.9%), with no statistical difference in both groups (p = 0.76). In a recent study by Aguilar et al, they found an ADR of 24.6%, made by Mexican endoscopists, but there were no fellows involved; this is really close to our data from gastroenterology fellows (23%) 16 .…”