Correlation Between Bowel Preparation and the Adenoma Detection Rate in Screening Colonoscopy

Abstract

PurposeThe adenoma detection rate is commonly used as a measure of the quality of colonoscopy. This study assessed both the association between the adenoma detection rate and the quality of bowel preparation and the risk factors associated with the adenoma detection rate in screening colonoscopy.MethodsThis retrospective analysis involved 1,079 individuals who underwent screening colonoscopy at the National Cancer Center between December 2012 and April 2014. Bowel preparation was classified by using the Aronchick scale. Individuals with inadequate bowel preparations (n = 47, 4.4%) were excluded because additional bowel preparation was needed. The results of 1,032 colonoscopies were included in the analysis.ResultsThe subjects' mean age was 53.1 years, and 657 subjects (63.7%) were men. The mean cecal intubation time was 6.7 minutes, and the mean withdrawal time was 8.7 minutes. The adenoma and polyp detection rates were 28.1% and 41.8%, respectively. The polyp, adenoma, and advanced adenoma detection rates did not correlate with the quality of bowel preparation. The multivariate analysis showed age ≥ 60 years (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.02–1.97; P = 0.040), body mass index ≥ 25 kg/m2 (HR, 1.56; 95% CI, 1.17–2.08; P = 0.002) and current smoking (HR, 1.44; 95% CI, 1.01–2.06; P = 0.014) to be independent risk factors for adenoma detection.ConclusionThe adenoma detection rate was unrelated to the quality of bowel preparation for screening colonoscopy. Older age, obesity, and smoking were independent risk factors for adenoma detection.

Effect of Sending Educational Video Clips via Smartphone Mobile Messenger on Bowel Preparation before Colonoscopy

“…Adequate bowel preparation can be expected to increase PDR and ADR during colonoscopy. However, several recent studies reported that PDR and ADR are not closely related to the quality of bowel preparation [18-20]. In our study, PDR and ADR were significantly lower in the SMM group than in the control group.…”

Microbiome and morbid obesity increase pathogenic stimulus diversity

“…Obesity has been strongly associated with precancerous lesions and conditions such as colon adenomas [68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][86], monoclonal gammopathy [87][88][89][90][91][92][93][94][95][96][97][98], chronic pancreatitis [99][100][101][102], or inflammatory bowel disease (IBD) [103][104][105][106]. Observed risks of cancers associated with obesity include breast [107][108][109][110][111], colorectal [112][113][114][115], pancreatic [99]…”

Limitation and Value of Using the Adenoma Detection Rate for Colonoscopy Quality Assurance

“…As a result, a proposal was recently made that the ADR be applied to patients older than 50 years of age. In the present study [ 3 ], age, body mass index, and smoking were factors associated with increased numbers of adenomas in the patients. In addition, prolonged observation time, observations during repeated insertions, changes in both the air volume and the position during observation, the use of a pigmented endoscope, and the use of a high-resolution electronic endoscope were factors associated with an increased ADR [ 4 ].…”