Adenoma Detection Rate Evaluation and Quality of Colonoscopy in the Center-West Region of Brazil

Abstract

-Background -Colorectal cancer is the third commonest cancer in men and the second in women worldwide. Peculiarities of its evolution allow secondary prevention measures through colonoscopy, with high diagnostic and therapeutic capacity. In this context, the quality indicators of the procedure become important, among them the adenoma detection rate (ADR). Objective -To relate the ADR in a medium risk population subjected to colonoscopy with sociodemographic, technical and histopathological indicators. Methods -This was a descriptive, observational and retrospective study whose data were collected from medical records of colonoscopy exams with the indication of colorectal cancer screening or prevention in the period from August to October 2016. Results -A total of 436 exams were included for analysis. Female sex represented 66.3% with 289 patients versus 33.7% for men. Patients aged between 50 and 59 years were 223 (51.1%) and those between 60 and 75 years were 213 (48.9%). In 99 exams (22.7%) chromoscopy was used, and 420 patients (96.3%) were adequately prepared. There were 118 patients with adenomas, resulting in an overall ADR of 27.1%. The ADR for men was 30.6% and 25.3% for women. Patients between 60 and 75 years old had a significantly higher ADR (31.9%, compared to 22.4% of the younger ones). Examinations in which chromoscopy was used also presented higher ADR. Conclusion -The ADR values found for the population of the studied region were compatible with internationally established goals. Continuous evaluation of the ADR may yield interventions aimed at improving quality standards for colonoscopy and promote better prevention of colorectal cancer. HEADINGS -Adenoma. Colorectal cancer. Colonoscopy.

ADR evaluation of screening colonoscopies during 2016 – 2017 in a private health clinic in Peru

“…For example, Abdul-Baki H. et al found a variation between ADR results obtained prior to the introduction of public reporting of colonoscopy quality (ADR 34.3 %) and those obtained once the transition to public reporting was completed (ADR 39.2 %) 19 . The overall ADR result of the current study is reasonably in line with those reported by others for screening colonoscopies, for example: in the United States 35.9 % 20 and in Brazil 27.1 % (females 25.3 % and males 30.6 %) 16 . In Peru there were two reports of ADRs for colonoscopies with indications other than screening: 10 % 21 and 27 %.…”

“…Two principal patient-specific factors determining prevalence of adenomas are patient age and sex 3 . In this study the ADR was higher in males than in females ( Table 1 ) and also higher with increasing patient age ( Table 2 ), confirming the results reported by others that there exists a relationship between patient age and sex and ADR 16 17 . The ADR result for each colonoscopist ( Table 3 ) indicates no relationship between the overall ADR and the colonoscopist and this appears to be at variance with other reports 3 .…”

“…Of the adenomas found, 51 % were located in the proximal colon, whereas others have reported finding the majority in the distal colon 9 11 16 18 . This difference could be due to there being a causal relationship with respect to the personal characteristics of the patient populations sampled, in addition to factors related to the degree of colonic preparation and colonoscopist experience, e. g. methods of examination and evaluation of the proximal colon 11 .…”

Assessment of Quality Indexes in Colonoscopy in the Coloproctology Service of a Tertiary Private Hospital in Southern Brazil

“…5,6 The findings of the present study validate the applicability of these global targets in the Southern Region of Brazil. Regarding other regions of the country, a study conducted in the Midwestern region by Cardoso et al, 23 found an ADR of 27.1% in colonoscopies performed for screening, with 25.3% among women and 30.6% among men. Another study, which was also conducted in Southern Brazil, but in the state of Santa Catarina, by Fiorentin et al, 24 found a general ADR of 19.8% in a private clinic.…”

The Esophageal, Gastric, and Colorectal Tumors and the Esophagogastroduodenoscopies and Colonoscopies by the Brazilian Unified Health System: What Is the Importance?

“…Esophagogastroduodenoscopies (EGDs) and colonoscopies (CLNs) are the most important examinations for the investigation of disorders of the upper and lower digestive tract and are considered essential for the diagnosis of both benign and malignant lesions. They are also the first option for the diagnosis of gastrointestinal diseases 5 , 11 , 22 , 30 .…”