Mo1636 THE IMPORTANCE OF RIGHT COLON ADENOMA DETECTION RATE AND ITS CORRELATION WITH OTHER QUALITY METRICS

Abstract

Right sided lesions are often missed during colonoscopy and could contribute to interval colon cancer development. This has led to the importance of Right Colon Adenoma Detection Rate (r-ADR) and its consideration as a colonoscopy quality metric. This is a retrospective analysis of a well-defined database at a tertiary academic facility of adult patients who had undergone an average risk screening colonoscopy between 2005 and 2015. Data were extracted for each endoscopist including: overall ADR, right and left colon ADR, sessile serrated ADR (SDR), advanced ADR and adenomas per colonoscopy (APC). The primary goal of the analysis was to determine the r-ADR and assess its correlation to overall ADR and APC. Standard pair matched analysis was performed using Pearson correlation coefficient (r) and was calculated using statistical software SAS. P- value of 0.05 was considered statistically significant. A total of 3,356 patients were included in the analysis; mean age 60.7 +/- 10.3 years; 95% male. The overall ADR was 60%, r-ADR 43.2%, advanced ADR was 16.9%, serrated ADR was 4.2% and documented cecal intubation rate was 98%. The mean APC was 1.7±2.4. A trainee was present for 67.4% of these procedures. There was high correlation of r-ADR (r=0.80; p=0.054); overall ADR (r=0.72; p=0.107), and advanced ADR (r=0.80; p=0.05) to APC respectively. The correlation of r-ADR to overall ADR was high (r=0.97; p<0.01). However, correlation of r-ADR to advanced ADR (r=0.33;p=0.52) and SDR (r=0.45; p=0.37) was modest . Right sided adenomas account for at least 70% of the overall ADR. r-ADR detection has high correlation with total adenomas per colonoscopy and overall ADR. If r-ADR is linked to interval colon cancer development, it can be considered as a new quality metric for colonoscopy.