Article: Serrated polyp detection rate and advanced adenoma detection rate from a US multicenter cohort
Authors: Jagpal S Klair, Munish Ashat, Dane Johnson, Sumant Arora, Nirmal Onteddu, Jose G Machain Palacio, Ronald Samuel, Mohammad Bilal, Avanija Buddam, Ashutosh Gupta, Alan Gunderson, Praveen Guturu, Kaartik Soota, Subhash Chandra, Arvind R Murali
Journal: Endoscopy. 2020 Jan;52(1):61-67. doi: 10.1055/a-1031-5672.
Background: Interval colorectal cancers may be associated with a low serrated polyp detection rate (SDR) and advanced adenoma detection rate (AADR). We aimed to determine the SDR and AADR for endoscopists in a United States multicenter cohort.
Methods: We included average-risk screening colonoscopies from five medical centers in the United States. Endoscopists with data on at least 100 average-risk screening colonoscopies were included. We calculated median SDR and AADR for endoscopists with adequate adenoma detection rates (ADRs) > 25 %. We analyzed the relationship between ADR and SDR, and between ADR and AADR using nonparametric Spearman correlation coefficients, scatter plots, and linear regression.
Results: We included 3513 screening colonoscopies performed by 26 gastroenterologists. The mean age of patients was 56.8 years (SD 7.4) and 1585 (45 %) were male. All but one endoscopist had an ADR above 25 %. There was a significant positive but modest correlation between ADR and SDR (rho = 0.67, P < 0.01), and between ADR and AADR (rho = 0.56, P < 0.01). For endoscopists with an adequate ADR, median (interquartile range) ADR was 43 % (32.0 % – 48.6 %), median SDR was 8.4 % (7.3 % – 11.4 %), and median AADR was 9.3 % (6.4 % – 12.6 %).
Conclusion: A significant percentage of endoscopists have either a low SDR or low AADR despite an adequate ADR, justifying the need for separate SDR and AADR benchmarks. Based on our multicenter cohort, endoscopists with adequate ADRs had a median SDR and median AADR of about 8 % and 9 %, respectively.
Link to journal online: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-1031-5672