Abstract
Introduction: Adenoma detection rate (ADR) is a widely used quality indicator for colonoscopy, but it requires histological evaluation and cumbersome to calculate. Therefore, Polypectomy rate (PR) has been proposed as an alternative quality measure. PR is simple to calculate and can be readily calculated at the time of colonoscopy and also from administrative records. Our aim was to determine the correlation of PR with the current threshold ADR (30% in men and 20% in women) from a large number of colonoscopies performed in a single center. Methods: A retrospective chart review of all screening colonoscopies in patients over 50 years of age performed at our institution between 2012 and 2014 was done. Patients who had complete colonoscopy with good, excellent and adequate bowel preparation were included. Patients with fair and poor preparation, and procedures performed by individual endoscopists' with less than 10 procedures each were excluded. Overall and gender specific ADR and PR were calculated. ADR was defined as proportion of colonoscopies with at least one adenoma and polypectomy rate (PR) was defined as the proportion of procedures in which at least 1 polyp was removed. A p value of < 0.05 was considered significant. Results: A total of 10,498 colonoscopies were screened out of which 4158 colonoscopies were included. These were performed by 85 multispecialty endoscopists (gastroenterologists-54, colorectal surgeons-20, others-11) with a median of 32 procedures each (Table 1). ADR was 26.4+ 10.9% overall, 32.7+ 14.5% in men, and 22.1 + 12.6% in women. PR was 45.4 ± 15.8 % overall, 52.3 ± 18.3 % in men, and 40.7 ± 18.4 % in women. There was good correlation between ADR and PR. PR correlating with current threshold ADR of 30% in men and 25% in women were 47% in men and 37% in women respectively (Figure 1).Figure 1Conclusion: PR of 47% in men and 37% in women correlate with the current threshold values for ADR which are 30% in men and 25% in women respectively. Given its ease of use and good correlation with ADR, PR may be used as surrogate quality indicator of colonoscopy. These findings need to be validated in further studies.Figure 2
Published Version
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