Sessile serrated adenoma detection rate correlates with adenoma detection rate in the proximal colon

Abstract

Objectives: As more focus is placed on right-sided colon cancer prevention, detecting and removing sessile serrated adenomas (SSAs) may play a major role in screening colonoscopies. Although SSA is currently included in the adenoma detection rate (ADR) and the polyp detection rate (PDR), it is not known whether these metrics have a strong correlation. Our objective was to evaluate the correlation of endoscopists’ sessile serrated adenoma detection rate (SSADR) with ADR. Methods: Screening colonoscopy reports in an outpatient, tertiary care endoscopy center were reviewed from October 2010 to September 2011. Corresponding pathology reports were recorded manually. ADR (proportion of screening colonoscopies with at least one adenoma removed), SSADR (proportion of screening colonoscopies with at least one SSA removed), and PDR (proportion of screening colonoscopies with at least one polyp removed) were calculated for each endoscopist. Pearson’s correlation coefficient and simple linear regression were used to evaluate the relationship between quality metrics. Results: 1797 colonoscopies performed by 20 endoscopists were reviewed in this study. Overall, mean (SD) for PDR was 47.7% (12.0), for ADR was 27.3% (6.9), and for SSADR was 3.8% (2.7). For SSAs specifically, mean size was 8.9 mm (8.5), and 87.0% were proximal to the splenic flexure. No significant correlation was seen between the overall ADR and the overall SSADR (r=0.42, p=0.065). However, these two indicators moderately correlated in the proximal colon (r=0.49; p=0.02). The endoscopists’ overall ADR and PDR did correlate well (r=0.68, p=0.001). Conclusions: SSAs are included in ADR calculation; although they do not correlate well overall, they do correlate closely in the proximal colon.