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Difference in Physician- and Patient-Dependent Factors Contributing to Adenoma Detection Rate and Serrated Polyp Detection Rate

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Abstract

Background

Adenoma detection rate (ADR) is correlated with the risk of interval colorectal cancer and is considered as a quality benchmark for colonoscopy. Serrated polyp detection rate (SPDR) might be a more stringent indicator of quality in polyp detection.

Aims

To evaluate in a 2-year monocentric observational study patient-dependent and endoscopist-dependent factors influencing ADR and SPDR in daily practice.

Methods

We determined ADR and SPDR. We collected patient-dependent factors and endoscopist-dependent factors. Links between these data and detection rates were assessed by uni- and multivariate analysis.

Results

A total of 11682 colonoscopies were performed (female: 54.3%; male: 45.7%; median age 58) by 30 endoscopists (female: 9; male: 21). ADR and SPDR were 29.2% and 8%, respectively. In multivariate analysis, ADR was associated with patient-dependent factors: age (OR 1.044, CI 95% 1.040–1.048), male gender (OR 1.7, CI 95% 1.56–1.85), personal history of polyp/cancer (OR 1.53, CI 95% 1.3–1.9), and positive fecal immunochemical test (OR 2.47, CI 95% 2.0–3.1). In multivariate analysis, SPDR was associated with withdrawal time (OR 1.25, CI 95% 1.17–1.32), low volume activity (OR 1.3, CI 95% 1.1–1.52), and personal history of polyp/cancer (OR 1.61, CI 95% 1.15–2.25).

Conclusion

In this large series of routine colonoscopies, we found that ADR was mainly driven by patient-dependent conditions, i.e., age, male gender, colonoscopy indication for positive FIT, and a personal history of polyp or cancer. In contrast, SPDR was mainly related to endoscopist-dependent factor, i.e., withdrawal time and low volume activity.

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Abbreviations

CRC:

Colorectal cancer

ADR:

Adenoma detection rate

SPDR:

Serrated polyp detection rare

BBPS:

Boston Bowel Preparation Scale

ANDR:

Advanced neoplasia detection rate

HP:

Hyperplastic polyp

SSA/P:

Serrated adenomas/polyps

TSA:

Traditional serrated adenomas

SD:

Standard deviation

IQR:

Interquartile range

FIT:

Fecal immunochemical test

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Acknowledgments

We acknowledge all the collaborators and nurses involved in this work: Dr. Azria, Dr. Bumsel, Dr. Chemtob, Dr. Chryssostalis, Dr. Cohen, Mrs. Cordier, Dr. Debou, Dr. Demont, Dr. Etienney, Dr. Evard, Dr. Gillot, Dr. Grateau, Dr. Guigui, Dr. Hagège, Dr. Harboun, Mrs. Hazoume, Dr. Lab, Dr. Lons, Dr. Mehtari, Mrs. Pattin, Dr. Pecriaux, Dr. Pellat, Mrs. Pereira, Dr. Petit, Mrs. Ricq, Dr. Roycourt, Mrs. Tselikas, Dr. Zago, Mrs. Zanardo, Dr. Zeitoun, Dr. Zrihen, and Dr. Zylberberg.

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Authors and Affiliations

  1. Endoscopy Unit, Clinique de Paris-Bercy, 9 Quai de Bercy, 94220, Charenton le Pont, France

    Maryan Cavicchi, Gaëlle Tharsis, Philippe Cattan, Franck Venezia, Gilles Tordjman, Agnès Gillet, Joëlle Samama, Karine Nahon-Uzan & David Karsenti

  2. Gastroenterology Unit, Gustave Roussy, 114, Rue Edouard-Vaillant, 94805, Villejuif Cedex, France

    Pascal Burtin

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  1. Maryan Cavicchi
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Cavicchi, M., Tharsis, G., Burtin, P. et al. Difference in Physician- and Patient-Dependent Factors Contributing to Adenoma Detection Rate and Serrated Polyp Detection Rate. Dig Dis Sci 64, 3579–3588 (2019). https://doi.org/10.1007/s10620-019-05808-y

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