Surgical Endoscopy

, Volume 29, Issue 2, pp 466–473

Endoscopists with low adenoma detection rates benefit from high-definition endoscopy

Authors

    • Division of Gastroenterology and Hepatology, Department of Internal Medicine IIIMedical University of Vienna
    • Quality Assurance Working GroupAustrian Society of Gastroenterology and Hepatology (OEGGH)
  • Martha Britto-Arias
    • Division of Gastroenterology and Hepatology, Department of Internal Medicine IIIMedical University of Vienna
    • Quality Assurance Working GroupAustrian Society of Gastroenterology and Hepatology (OEGGH)
  • Irina Gessl
    • Division of Gastroenterology and Hepatology, Department of Internal Medicine IIIMedical University of Vienna
    • Quality Assurance Working GroupAustrian Society of Gastroenterology and Hepatology (OEGGH)
  • Georg Heinze
    • Division of Clinical Biometrics, Department for Medical StatisticsMedical University of Vienna
  • Petra Salzl
    • Division of Gastroenterology and Hepatology, Department of Internal Medicine IIIMedical University of Vienna
    • Quality Assurance Working GroupAustrian Society of Gastroenterology and Hepatology (OEGGH)
  • Daniela Sallinger
    • Division of Gastroenterology and Hepatology, Department of Internal Medicine IIIMedical University of Vienna
    • Quality Assurance Working GroupAustrian Society of Gastroenterology and Hepatology (OEGGH)
  • Michael Trauner
    • Division of Gastroenterology and Hepatology, Department of Internal Medicine IIIMedical University of Vienna
    • Quality Assurance Working GroupAustrian Society of Gastroenterology and Hepatology (OEGGH)
  • Werner Weiss
    • Quality Assurance Working GroupAustrian Society of Gastroenterology and Hepatology (OEGGH)
  • Arnulf Ferlitsch
    • Division of Gastroenterology and Hepatology, Department of Internal Medicine IIIMedical University of Vienna
    • Quality Assurance Working GroupAustrian Society of Gastroenterology and Hepatology (OEGGH)
  • Monika Ferlitsch
    • Division of Gastroenterology and Hepatology, Department of Internal Medicine IIIMedical University of Vienna
    • Quality Assurance Working GroupAustrian Society of Gastroenterology and Hepatology (OEGGH)
Article

DOI: 10.1007/s00464-014-3688-2

Cite this article as:
Waldmann, E., Britto-Arias, M., Gessl, I. et al. Surg Endosc (2015) 29: 466. doi:10.1007/s00464-014-3688-2

Abstract

Background

An endoscopists adenoma detection rate (ADR) of less than 20 % correlates with high risk for occurrence of interval cancer. The impact of high-definition (HD) imaging on the ADR is discussed controversially. We aimed to investigate whether detection rates of individual endoscopists increase within 1 year before and 1 year after the switch from standard to HD endoscopy.

Methods

This cohort study analyzed 6,330 screening colonoscopies (2,968 with standard and 3,362 with HD) performed by 42 endoscopists between November 2007 and March 2013 within a nationwide quality assurance program for screening colonoscopy.

Results

The ADR of endoscopists with a low ADR (<20 %) increased significantly higher (from 11.8 to 18.1 %, p = 0.003) than of those with a high ADR (≥20 %) (from 28.6 to 30.7 %, p = 0.439) after switch from standard to HD colonoscopes (p = 0.0076). The proportion of endoscopists with an ADR < 20 % decreased from 45 to 42.9 % (p = 0.593). There was no significant increase in age- and sex-adjusted detection rates of adenomas (20.2 vs 23.7 %; p = 0.089), advanced adenomas (4.7 vs 5.5 %; p = 0.479), flat adenomas (2.7 vs 3.1 %; p = 0.515), polyps (38.8 vs 41.5 %; p = 0.305), proximal polyps (18.5 vs 20 %; p = 0.469) and hyperplastic polyps (15 vs 17.2 %; p = 0.243) of endoscopists after switch to HD colonoscopes. There was no difference in detection rates of flat polyps (5.5 vs 5.5 %; p = 0.987).

Conclusions

The use of HD scopes is associated with marginal improvement in adenoma detection rates limited to those endoscopists with low adenoma detection rates prior to its introduction.

Keywords

Colorectal cancerEndoscopyTechnicalQuality control

Copyright information

© Springer Science+Business Media New York 2014