Relationship between the polyp detection rate and the post-colonoscopy colorectal cancer rate

Lozano, Violeta María Sastre; Sánchez, S. Morán; García‐Solano, José; Zamora, Pablo Conesa; Merino, Guadalupe Ruíz

doi:10.17235/reed.2019.5889/2018

Cited by 4 publications

(4 citation statements)

References 24 publications

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“…In addition, PDR, with a much simpler calculation than ADR, is another valuable quality indicator of colonoscopy. According to Sastre Lozano VM, IC prevalence was inversely and strongly associated with PDR of endoscopists ( 32 ). Therefore, ADR and PDR have been widely advocated as important quality indicators for colonoscopy screening.…”

Section: Discussionmentioning

confidence: 99%

Anesthesia Assistance in Colonoscopy: Impact on Quality Indicators

Liang

Zhang

et al. 2022

Front. Med.

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BackgroundAdenoma detection rate (ADR) and polyp detection rate (PDR) are both indicators for colonoscopy quality. Improving ADR or PDR is critical for reducing the incidence and mortality of colorectal cancer (CRC). Although several studies have focused on identifying the factors that may influence ADR or PDR, the evidence remains limited and inconclusive. We conducted a retrospective study to evaluate the effect of anesthesia assistance (AA) on ADR or PDR in patients undergoing colonoscopy screening and identify risk factors affecting ADR or PDR.MethodsWe reviewed electronic medical records of patients who underwent colonoscopy screening between May 2019 and August 2020. Patients were divided into two groups according to whether they received AA: patients in Group A underwent colonoscopy screening with AA, whereas patients in Group O underwent colonoscopy screening without AA. Propensity score matching (PSM) was utilized to account for differences in baseline characteristics. After, ADR and PDR were compared between the two groups. Binary logistic regression was employed to identify risk factors that affected ADR or PDR.ResultsOf 9432 patients who underwent colonoscopy examination during the study period, 7170 were included in the final analyses (Group A = 5756 and Group O = 1414). After PSM, 736 patients remained in each group for analyses. There was no significant difference between groups A and O (P > 0.05) in ADR or PDR. Binary logistic regression indicated that the endoscopic device version (Olympus HQ290), equipment image-based technique and number of images were independent risk factors that affected ADR, and the age (50–59 years and 60–69 years), gender (male), high-risk status, endoscopist seniority (senior endoscopist), equipment image-based technique and number of images were all independent risk factors that affected PDR.ConclusionsWe discovered that AA does not affect ADR or PDR. Despite improved patient satisfaction, using AA is unnecessary for improving colonoscopy quality. Endoscopists should consider all these factors as much as possible when performing colonoscopy screening.

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Section: Discussionmentioning

confidence: 99%

Anesthesia Assistance in Colonoscopy: Impact on Quality Indicators

Liang

Zhang

et al. 2022

Front. Med.

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“…Our results show that regular feedback to individual endoscopists is associated with an overall improvement of departmental performance across multiple KPIs. The significant improvement in ADR from 12.7% to 21.0% is important because missed adenomas increase the risk of post-endoscopy colorectal cancer 4–6 18. ADR is indeed considered the best indicator of colonoscopic quality and is less susceptible to ‘gaming’ behaviours compared with more easily assessed KPIs, such as PDR and withdrawal time 19 20…”

Section: Discussionmentioning

confidence: 99%

“…The monitoring of key performance indicators (KPIs) is useful to standardise and improve quality in endoscopy 3. The adenoma detection rate (ADR) and its proxy, polyp detection rate (PDR), are considered the best surrogates of high-quality colonoscopy because they inversely correlate with the risk of interval colorectal cancer diagnosis and death 4–6…”

Section: Introductionmentioning

confidence: 99%

Regular feedback to individual endoscopists is associated with improved adenoma detection rate and other key performance indicators for colonoscopy

Lim

Tritto

Zeki

et al. 2022

Frontline Gastroenterol

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ObjectiveMonitoring of key performance indicators (KPIs) is a vital element of endoscopy quality improvement. Adenoma detection rate (ADR) is considered the best marker for colonoscopic quality as it inversely correlates with subsequent colonic cancer incidence and mortality, while polyp detection rate (PDR) is an easier-to-calculate surrogate for ADR. This study assessed whether regular feedback to individual endoscopists about their KPIs improved departmental performance.MethodsIndividual KPIs were calculated for a period of 8 years (January 2012–December 2019) and fed back to all endoscopists at 6 monthly intervals, alongside anonymised indicators for other endoscopists, aggregate departmental performance data and benchmarks. An automated natural language processing software (EndoMineR) was used to identify adenomas in pathology reports and calculate ADR. Linear regressions were calculated for departmental ADR, PDR and other KPIs at 6 monthly intervals.Results39 359 colonoscopies (average 2460 in every 6-month period, range 1799–3059) were performed by an average of 42 (range 34–50) endoscopists. A continuous improvement in collective performance including ADR (12.7%–21.0%, R2 0.92, p<0.001) and PDR (19.0%–29.6%, R2 0.77, p<0.001) was observed throughout the study. Other KPIs showed similar improvement. The detection of non-neoplastic polyps did not increase. When analysed separately, ADR and PDR appeared to improve for gastroenterologists and nurse endoscopists but not for surgeons.ConclusionRegular feedback with individual and departmental KPIs was associated with improved ADR and overall performance throughout the 8-year study period. Concomitant monitoring of ADR and PDR may prevent ‘gaming’ behaviour and ensure that genuine improvement is achieved.

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“…The ADR is the most closely related metric to the development of post-colonoscopy colorectal cancer or interval colorectal cancer and is an indicator of colonoscopy quality; another valuable indicator of colonoscopy quality is the polyp detection rate, which is much simpler to calculate than the ADR [9,21]. Approximately half of diminutive polyps (polyp size, <5 mm in diameter), which are the vast majority of polyps found during colonoscopy, are adenomatous and present with low risk of advanced neoplasia.…”

Section: Discussionmentioning

confidence: 99%

Performance comparison of reusable versus disposable colonoscopes:a non-inferiority Trial

Wei

hai

Ruan

et al. 2022

Preprint

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Objective: We herein compared the performance of reusable and disposable colonoscopes in patients scheduled to undergo colonoscopy with a view of preventing patient cross-infection, protecting the safety of clinical medical staff, reducing the risk of infection, and minimizing the decontamination process, particularly during the coronavirus disease 2019 pandemic. Methods: We randomly divided patients meeting the enrollment criteria into reusable and disposable colonoscopy groups; the success rate of photographing customary anatomical sites with a non-inferiority margin of -8% was the primary endpoint. Secondary endpoints were the adenoma detection rate, operation time, endoscopic image quality score, endoscopic mucosal resection (EMR) success rate, and adverse events. Results: We recruited patients who were treated using reusable or disposable (n = 45, each) colonoscopes. Both groups had 100% success rate for capturing images of customary anatomical sites, with no between-group differences. The lower limit of 95% CI was -7.8654%, which was greater than the non-inferiority threshold of -8%. The disposable group had a significantly lower average image quality score (26.09plus-or-minus sign1.33 vs. 27.44plus-or-minus sign0.59, P < 0.001) than the reusable group. The groups did not significantly differ in maneuverability, safety, or device failure/defect rate. The en-bloc EMR success rate was 100% in both groups. EMR took significantly longer in the disposable group (466.18 splus-or-minus sign180.56 s vs. 206.32 splus-or-minus sign109.54 s, P < 0.001). The incidence of EMR-related bleeding and perforation did not significantly differ between the groups. Conclusions: Disposable colonoscope endoscopy is safe and feasible for endoscopy examinations and EMR.

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Relationship between the polyp detection rate and the post-colonoscopy colorectal cancer rate

Cited by 4 publications

References 24 publications

Anesthesia Assistance in Colonoscopy: Impact on Quality Indicators

Anesthesia Assistance in Colonoscopy: Impact on Quality Indicators

Regular feedback to individual endoscopists is associated with improved adenoma detection rate and other key performance indicators for colonoscopy

Performance comparison of reusable versus disposable colonoscopes:a non-inferiority Trial

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