Adenoma detection rates in an opportunistic screening colonoscopy program in Iran, a country with rising colorectal cancer incidence

Abstract

BackgroundData on the quality of colonoscopies in populations with rising colorectal cancer (CRC) incidence is scarce. We aimed to calculate the adenoma detection rates (ADR), and assess the quality of colonoscopies in an opportunistic screening colonoscopy program in Iran.MethodsAll the colonoscopy and pathology reports of asymptomatic adults over age 50 who underwent screening colonoscopy between June 2007 and March 2013 were reviewed. The colonoscopy quality indicators including ADR were calculated, and patient factors associated with the adenoma detection were determined.ResultsA total of 713 asymptomatic adults aged 50 years and older who underwent their first-time screening colonoscopy were included in this study. ADR and advanced-ADR were 33.00% (95% CI: 29.52-36.54) and 13.18% (95% CI: 10.79-15.90), respectively. We observed a significantly higher rate of cecal intubation in patients with fair or better bowel preparation compared to those with poor prep, 90.00% vs. 70.45%, respectively (P < 0.001). Bowel preparation (adjusted OR: 2.49, 95% CI: 1.75-3.55), older age (≥60) (adjusted OR: 1.70, 95% CI: 1.22-2.36), and male gender (adjusted OR: 1.39, 95% CI: 1.01-1.92) were associated with the adenoma detection.ConclusionsOur ADR in both genders meets and exceeds the recommended colonoscopy quality benchmarks. The polyp and adenoma detection rates in the current study are comparable to those reported from Western countries where the incidence of CRC is traditionally high. These data are in line with the epidemiologic transition of CRC in Iran.

Opportunistic Colorectal Cancer Screening using Colonoscopy. Comparative Results between two Historical Cohorts in Bucharest, Romania

“…However, these were probably advanced cancers as they all needed surgery for treatment, while in our cohort we counted in the adenocarcinoma group the endoscopically removed superficial cancers. In a similar study to our study, regarding opportunistic CRC screening in Iran by colonoscopy in individuals above 50, Delavari et al [20] obtained an adenoma detection rate of 33%, an advanced adenoma detection rate of 13.18% and an adenocarcinoma rate of 0.84%. In Romania, in Timis and Mures County, Sporea et al [30] reported a much higher adenoma detection rate of 32.1%, but with an almost identical 9.2% advanced neoplasia detection rate (2,433 colonoscopies from three centers in a 5-year interval, 2008-2013).…”

“…However, it may be an alternative when organized screening programs are not available. Colorectal cancer screening in Taiwan using the FIT test [18] and in Germany or Iran using colonoscopy [19,20] has been reported. Recently, it has been advocated in Romania, considering the lack of such an organized program [21].…”

Epidemiology of Gastroesophageal Reflux Disease in Iran: A Systematic Review and Meta-analysis

“…In a systematic review in Iran, the causes of heterogeneity for the prevalence of GERD have been attributed to different criteria such as definition, difference in social factors, cultural background, and lifestyle in different cities or different populations (52). On the other hand, due to the limitations of population-based studies, where precise diagnostic methods such as PH metric testing cannot be used, some of these differences can be due to the lack of a comprehensive standard for classifying symptoms and complications of GERD, which makes comparison between studies difficult (53). Some differences in reported reflux rates may be due to cultural and ethnic differences in perceiving, expressing, and understanding symptoms of reflux.…”

Assessment of Bone Morphogenetic Protein 3 Methylation in Iranian Patients with Colorectal Cancer

“… 1 It is estimated that the global CRC rates will double over the next two decades because of a growing increase in the incidence of the disease in the developing countries. 2 According to the Iranian Annual National Cancer Registration Report, CRC is the third most common cancer in Iranian women and fifth in men. Its incidence has increased during the last 25 years dramatically.…”