S0282 Adenoma Detection Rates for Colonoscopy and Associated Factors: Results From a U.S. Sample Using the GIQuIC Registry

Abstract

INTRODUCTION: Adenoma Detection rate (ADR) is an established quality indicator for screening colonoscopy. However, reported ADRs are highly variable across practices, and national or population-based estimates are not available. The aim of our study was to study the ADR, variability of rates over time and factors associated with detection rates of ADR in a national sample of patients undergoing colonoscopy using the GIQuIC registry. METHODS: We used colonoscopies submitted to the GIQuIC registry from 2014 to 2018 on adults ages 50–89. Only the first colonoscopy record per patient was included. Indications for colonoscopy were categorized as screening, diagnostic and surveillance. We used hierarchical logistic models to study factors associated with ADR. RESULTS: A total of 2,646,833 colonoscopies were performed by 1,169 endoscopists during the study period. The average ADR for screening colonoscopies per endoscopist was 36.80% (SD 10.21), 44.08 (SD 10.98) in males and 31.20 (SD 9.65) in females. Adjusted to the US population, the ADR was 39.08%. There was a significant increase in ADR from screening colonoscopies over the study period from 33.93% in 2014 to 38.12% in 2018. Clinically significant factors associated with higher ADR were age (OR 1.28; 95% CI 1.27–1.29 for 60–69; 1.57, 95% CI 1.55–1.58 for 70–79 compared to 50–59 years), male gender (OR 1.57; 95% CI 1.56–1.58), surveillance indication (vs. screening; OR 1.24; 95% CI 1.22, 1.26) and longer withdrawal times (>11 minutes vs. ≤6 minutes) (OR 10.07; 95% CI 9.51–10.66). CONCLUSION: Population based estimates of detection rates of ADR are 36.60% and have increased over time. Factors associated with ADR were patient age, gender and longer withdrawal time.Figure 1.: ADR for men and women over 20-14-2018.Figure 2.: Trends of ADR by indication over time.