Gastroenterologists Have Higher Polyp Detection Rates During Screening Colonoscopy Than Non-gastroenterologists

Abstract

Introduction: It has been reported that gastroenterologists are better at polyp detection and polyp removal as compared to Non-gastroenterologists. After a negative colonoscopy, those who have had their procedures performed by a gastroenterologist are less likely to develop interval CRC. However specific information about polypectomy rate (PR), adenoma detection rate (ADR), serrated polyp detection rate (SPDR) and sessile serrated adenoma detection rate (SSADR) and their variation by gender and colonic segment between gastroenterologist and non-gastroenterologists is not clearly defined. Methods: A retrospective review of all screening colonoscopies in patients ≥50 years of age performed at our institution between 2012 and 2014 was done. Patients with complete colonoscopy with excellent, good and adequate bowel preparation were included. Non-gastroenterologists included general surgeons, colorectal surgeons and primary care physicians. Serrated polyps included hyperplastic polyps and sessile serrated adenomas. Overall, gender and colon segment specific PR, ADR, SPDR and SSADR were calculated and compared using t-tests. Data are presented as mean ± standard deviation. All analyses were done using SAS (version 9.4, The SAS Institute, Cary, NC) and a P<0.05 was considered statistically significant.Table: Table. Characteristics of Endoscopists and PatientsTable: Table. Polyp Detection Rates by Specialty of the EndoscopistResults: A total of 4151 patients were included in the analysis. Average patient age was 60.0±7.7 years and 53.2% were females. Colonoscopies were performed by 54 gastroenterologists (63.5%) and 31 (36.5%) non-gastroenterologists (General Surgeons=9; Colorectal Surgeons=21; Primary care physician=1). Overall PR (49.3±14.9 vs. 37.5±14.9; P<0.05) and overall ADR (28.8±10.5 vs. 22.1±10.8; P=0.007) was significantly higher for gastroenterologists compared to non-gastroenterologists in both males and females; Overall SSADR and proximal SSADR was significantly higher for gastroenterologists compared to non-gastroenterologists. Overall SPDR is significantly higher for gastroenterologists; however proximal and distal SPDR did not vary significantly by the specialty of endoscopist or gender of the patient. Conclusion: Gastroenterologists have higher PR, ADR, SPDR, SSADR and proximal SSADR compared to non-gastroenterologists. These findings suggest a need for developing targeted programs to improve colonoscopy quality for non-gastroenterologists performing colonoscopy.