Adenoma Detection Rate and Colonoscopy Indication: Beyond Screening Procedures

Mangas-Sanjuán, Carolina; Santana, E; Cubiella, Joaquín; Seoane, Agustín; Suárez, Adolfo; Quintero, Enrique; Ferrández, Ángel; Hernández, Vicent; Ponce, Marta; Portillo, Isabel; Pellisé, María; Díez-Redondo, Pilar; Herraiz, Maite; Ono, Akiko; Pizarro, Ángeles; Zapater, Pedro; Jover, Rodrigo

doi:10.1055/s-0039-1681465

Cited by 3 publications

(3 citation statements)

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“…The overall rate of colonoscopies with adequate bowel preparation also reached the minimum standard of ≥ 90 % proposed by the ESGE 4 . In this study, the rates of adequate bowel preparation per indication were higher than described in a previous publication 13 . Further studies are needed to assess the association between the quality of bowel preparation and patient and endoscopy characteristics, such as indication.…”

Section: Discussioncontrasting

confidence: 58%

Continuous monitoring of colonoscopy performance in the Netherlands: first results of a nationwide registry

et al. 2021

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Background: To optimize colonoscopy quality, several performance measures have been developed. These are usually assessed without distinction between the indications for colonoscopy. This study aims to assess the feasibility of linkage between two registries: a national colonoscopy registry and a national registry for adverse events of gastrointestinal endoscopies in the Netherlands, and to describe the results of colonoscopy quality per indication. Methods: This retrospective study was conducted with prospectively collected data of the Dutch Gastrointestinal Endoscopy Audit (DGEA) and the Dutch Registration of Complications in Endoscopy (DRCE). Data between 01-01-2016 and 01-01-2019 were analyzed. To calculate adverse event rates, data were linked to the level of endoscopy service. Results: During the 3-year study period, 266.981 colonoscopies were recorded in DGEA. Of all indications, cecal intubation rate was highest in fecal immunochemical test (FIT)-positive screening colonoscopies (97.1%), followed by surveillance (93.2%), diagnostic (90.7%) and therapeutic colonoscopies (83.1%). The highest rate of adequate bowel preparation was observed in FIT-positive screening colonoscopies (97.1%). A total of 1540 (0.58%) adverse events occurred after colonoscopies. Perforation and bleeding rates were highest for therapeutic (0.51% and 1.56%, respectively) and FIT-positive screening colonoscopies (0.06% and 0.72%, respectively). The colonoscopy-related mortality was 0.006%. Conclusion: This study describes the first results of the Dutch national colonoscopy registry, which was successfully linked with data of the national registry for adverse events of gastrointestinal endoscopies. In this large dataset, performance measures varied per indication. Our results emphasize the importance of defining benchmarks per indication in future guidelines.

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Section: Discussioncontrasting

confidence: 58%

Continuous monitoring of colonoscopy performance in the Netherlands: first results of a nationwide registry

et al. 2021

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“…Convolutional neural networks (CNNs) are a class of deep neural networks that are highly effective in image and video analysis. Initial studies consistently showed that CNN-based systems effectively support the endoscopist in evaluating colonoscopy images, making the identification of colonic polyps easier 7 8 9 10 11 12 13 14 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a computer-aided detection system in a fecal immunochemical test-based organized colorectal cancer screening program: a randomized controlled trial (AIFIT study)

et al. 2022

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Background and aim: Computer-Aided Detection (CADe) increases adenoma detection in primary screening colonoscopy. The potential benefit of CADe in a fecal immunochemical test (FIT)-based colorectal cancer (CRC) screening programs is lacking. This study assesses whether the use of CADe increases the Adenoma Detection Rate (ADR) in FIT-based CRC screening program. Patients and methods: In a multicenter, randomized trial, 50-74 years old FIT-positive subjects undergoing colonoscopy, were randomized (1:1) to receive high-definition white light (HDWL) colonoscopy, with or without a real-time deep-learning CADe (CADEYE Fujifilm Co., Tokyo, Japan) by endoscopists with baseline ADR>25%. Main outcomes were ADR (primary outcome), mean number (SD) of adenomas per colonoscopy (APC) and advanced adenoma detection rate (Advanced-ADR). Subgroup analysis according to baseline endoscopists’ ADR (group 1: <40%, group 2: 41-45%, group 3 >46%) was also performed. Results: Eight hundred subjects (median age: 61.0 years, IQR: 55-67; 409 men) were included: 405 underwent CADe-assisted and 395 HDWL colonoscopy, respectively. ADR and APC were significantly higher in the CADe than in the HDWL arm: ADR: 53.6%; 95%CI: [48.6-58.5%] vs. 45.3%; 95%CI [40.3-50.45] (RR: 1.180; 95%CI: [1.026-1.361]); APC: 1.13 (1.54) vs. 0.90 (1.32), p=0.028. No significant difference in advanced-ADR (18.5%; 95%CI [14.8-22.6%] vs. 15.9%; 95%CI [12.5-19.9%]) was found. An increase in ADR was observed in all endoscopists' groups regardless of baseline ADR. Conclusions: Incorporating CADe significantly increases ADR and APC in the framework of a FIT-based CRC screening program. The impact of CADe appears to be consistent regardless of the endoscopist baseline ADR.

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“…Hiperplastik polipler bugün en çok tartışılan polip grubudur, geleneksel sınıflandırmada neoplastik değildirler, ancak çalışmalarda bu poliplerin serrated polipler olarak bilinen daha büyük bir polip grubunun bir parçası olduğu belirtilmektedir. Serrated poliplerin değişken malign potansiyele sahip heterojen bir polip grubu olduğu düşünülmektedir (7,8). Bu bilgiler ışığında neoplastik polip grubunun ve tüm kolorektal polip tiplerinin en sık görülen histolojik lezyonu olan adenomatöz poliplerin tanınması ve eksizyonu KRK ilişkili mortaliteyi azaltmakta ve sağ kalımı arttırmaktadır (9-11).…”

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Kolorektal polip sonuçlarımız; endoskopik ve histolojik verilerimizin güncel çalışmalarla karşılaştırılması

Bulur¹,

Yumuştutan²

2020

Endoskopi Gastrointestinal

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Kolorektal polipler, mukoza veya submukoza epitelinden köken alan, barsak lümeni içine çıkıntı yapıp kitle oluşturan lezyonlardır (1,2). Polipler kolorektal kanserlerin (KRK) öncü lezyonları olmalarından dolayı önem arz etmektedir. KRK dünyada ve Türkiye'de en yaygın görülen kanserlerdendir ve kansere bağlı mortalite ve morbiditenin önde gelen nedenlerindendir (3,4). Histolojik özelliklerine göre polipler genel anlamda neoplastik (benign: adenomalar, malign: kar-Bacground and Aims: Colorectal cancer is one among the most frequent cancers globally, and it usually results from colorectal polyps. We herein aimed to reveal the endoscopic and histological features of such polyps, and the prevalence of such polyps in our unit. Materials and Methods: Colonoscopic procedures carried out for any reason in adult patients in our endoscopy laboratory of the gastroenterology unit between 2016 and 2019 were retrospectively screened with an approval of the ethics committee. Polyps that were encountered in colonoscopic procedures and underwent polypectomy with the help of snare or forceps or biopsied were seperated and endoscopic (localization, size, and count) and histological (histopathological diagnosis, dysplasia, and cancer) features of the identified polyps were studied. The resulting data were analyzed in IBM SPSS 22.0. Results: In our study, one or more polyps were found in 362 (17.50%) of the colonoscopy procedures of 2068 patients. Mean age of patients with a polyp was 59.86±11 (19-92) years; mean age of men was 60.36 years and mean age of women was 59.16 years. Of all cases, 236 (65%) were men, and 126 (35%) were women. The distribution of polyps by size in our study was as follows: 298 (66.81%) diminutive polyps, 117 (26.23%) small polyps, and 31 (6.95%) large polyps. Polyps were found to be localized mostly in the sigmoid colon (n = 158, 35.42%), and least frequently in the cecum. In our study, polyps were histologically examined under two main categories as neoplastic ones (n = 270, 60.54%) and non-neoplastic ones (n = 179, 39.46%). The most common histological diagnosis was adenomas from the group of neoplastic polyps (n = 254, 56.95%), and the most frequent type of adenoma was tubular adenoma (n = 222, 87.40%). The second most common diagnosis after adenomas was hyperplastic polyps (n = 131, 29.4%). A low-grade dysplasia in 246 (55.16%) polyps, a high-grade dysplasia in 6 (1.35%) polyps, and an intramucosal adenocarcinoma in 1 (0.22%) polyp were identified when dysplasia/cancer features of polyps were reviewed. An increasing number of neoplastic features was apparent toward the proximal colon. Conclusion: This study was carried out in comparison with the recent studies on the prevalence of colon polyps. In our study, the presence of an increased frequency of polyps having dysplastic features, along with colorectal polyps, which is close to the respective prevalence rate in our country, compared to that in similar studies, was also noteworthy. This reaffirmed the importance of colonoscopy screening and follow-up p...

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Adenoma Detection Rate and Colonoscopy Indication: Beyond Screening Procedures

Cited by 3 publications

References 0 publications

Continuous monitoring of colonoscopy performance in the Netherlands: first results of a nationwide registry

Continuous monitoring of colonoscopy performance in the Netherlands: first results of a nationwide registry

Efficacy of a computer-aided detection system in a fecal immunochemical test-based organized colorectal cancer screening program: a randomized controlled trial (AIFIT study)

Kolorektal polip sonuçlarımız; endoskopik ve histolojik verilerimizin güncel çalışmalarla karşılaştırılması

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