Adenoma Detection Rate in a Community Setting Is Similar to Academic Setting: A 9-Month Prospective Study

Abstract

Introduction: Adenoma detection rate (ADR) is an important quality indicator for screening colonoscopies. The recommended benchmark ADR for screening examinations is 20% (15% for women; 25% for men ≥50 years old). In addition, data suggest a higher ADR in surveillance exams versus screening exams. We measured ADR in screening and surveillance colonoscopies in this study. Methods: ADR was prospectively recorded in all patients over a 9-month period at a community ambulatory surgery center. Screening colonoscopies were performed in adults based on USPSTF criteria. Surveillance colonoscopies were performed per guidelines on subjects who had a history of adenomatous polyps or colon cancer. Data was securely recorded in spreadsheet format. No unique patient identifiers were recorded at time of data entry. Two endoscopists were responsible for performance of colonoscopies. Results: A total of 748 screening colonoscopies were performed, while 134 surveillance colonoscopies were performed. The cecal intubation rate was 99.8% (747/748). The complication rate in the overall cohort was 0.01% (1/748). One or more than 1 adenoma was found in 248 patients (33%) in the screening group. In the surveillance cohort, 67 examinations (50%) revealed at least 1 adenoma. Conclusion: ADR in the community is at par with academic settings. We found ADR to be significantly higher in surveillance group as compared to screening group. In addition, colonoscopy can be performed efficaciously and safely in the community setting while maintaining quality standards for CRC prevention.