Abstract
Measures shown to improve the adenoma detection during colonoscopy (excellent bowel preparation, cecal intubation, cap fitted colonoscope to examine behind folds, patient position change to optimize colon distention, trained endoscopy team focusing on detection of subtle flat lesions, and incorporation of optimum endoscopic examination with adequate withdrawal time) are applicable to clinical practice and, if incorporated are projected to facilitate comprehensive colonoscopy screening program for colon cancer prevention. To determine adenoma and serrated polyp detection rate under conditions designed to optimize quality parameters for comprehensive screening colonoscopy. Retrospective analysis of data obtained from a comprehensive colon cancer screening program designed to optimize quality parameters. Academic medical center. Three hundred and forty-three patients between the ages of 50 years and 75 years who underwent first screening colonoscopy between 2009 and 2011 among 535 consecutive patients undergoing colonoscopy. Comprehensive colonoscopy screening program was utilized to screen all patients. Cecal intubation was successful in 98.8% of patients. The Boston Bowel Preparation Scale for quality of colonoscopy was 8.97 (95% confidence interval [CI]; 8.94, 9.00). The rate of adenoma detection was 60% and serrated lesion (defined as serrated adenomas or hyperplastic polyps proximal to the splenic flexure) detection was 23%. The rate of precancerous lesion detection (adenomas and serrated lesions) was 66%. The mean number of adenomas per screening procedure was 1.4 (1.2, 1.6) and the mean number of precancerous lesions (adenomas or serrated lesions) per screening procedure was 1.6 (1.4, 1.8). Retrospective study and single endoscopist experience. A comprehensive colonoscopy screening program results in high-quality screening with high detection of adenomas, advanced adenomas, serrated adenomas, and multiple adenomas.
Highlights
Colonoscopic removal of adenomatous colon polyps has been shown to reduce the incidence of colorectal cancer and to prevent death from colorectal cancer [1, 2]
The adenoma detection rate is an independent predictor of the risk of interval cancer and the ability of colonoscopy to reduce the incidence of colorectal cancer depends on the removal of adenomas [1, 6]
This study demonstrates that a comprehensive colonoscopy screening program designed to optimize quality parameters results in a high adenoma and serrated polyp detection rate which exceeds current quality standards
Summary
Colonoscopic removal of adenomatous colon polyps has been shown to reduce the incidence of colorectal cancer and to prevent death from colorectal cancer [1, 2]. The adenoma detection rate is an independent predictor of the risk of interval cancer and the ability of colonoscopy to reduce the incidence of colorectal cancer depends on the removal of adenomas [1, 6]. Measurement of adenoma detection has been included in quality-improvement programs for colorectal cancer screening [7, 8]. The US Multi-Society Task Force on Colorectal Cancer has established target adenoma detection rates of >25% for men, and >15% for women undergoing screening colonoscopy [9]. The NHS Bowel Cancer Screening Program in the United Kingdom recommended target adenoma detection rate of !40% and mean adenoma detection per patient of 1.20 in patients [10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
