Factors Associated with Adenoma Detection Rate and Diagnosis of Polyps and Colorectal Cancer during Colonoscopy in France: Results of a Prospective, Nationwide Survey

Barret, Maximilien; Boustière, Christian; Canard, J. M.; Arpurt, Jean‐Pierre; Bernardini, David; Bulois, P.; Chaussade, Stanislas; Héresbach, D.; Joly, Isabelle; Lapuelle, J.; Laugier, R.; Lesur, Gilles; Pienkowski, P.; Ponchon, Thierry; Pujol, B.; Richard-Molard, B.; Robaszkiewicz, Michel; Systchenko, R.; Abbas, Fatima; Schott-Péthelaz, Anne-Marie; Cellier, Christophe

doi:10.1371/journal.pone.0068947

Cited by 48 publications

(43 citation statements)

References 27 publications

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“…However, we found total ADR (31.5%), ADR in men (40.4%) and ADR in women (24%) higher than the minimum benchmarks recommended for screening colonoscopies (total ADR of 25%, ADR of 30% for men and 20% for women [10]). In addition, similar to the results of previous studies, the total ADR in men was found to be significantly higher, compared with that in women in the present study [17][18].…”

Section: Discussionsupporting

confidence: 92%

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Adenomų radimo dažnis atliekant prevencines kolonoskopijas: vieno centro patirtis

Pilvinytė¹,

Mašalaitė²,

Stanaitis³

2017

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ObjectiveAdenoma detection rate (ADR) is a recommended quality measure for screening colonoscopies in risk population. The main aim of our study was to calculate ADR in Vilnius University Hospital Santariskiu Klinikos (VUH SK) and determine interindivid ual variations among practicing endoscopists. Material and methodsRetrospective data review of all the patients who underwent screening colonoscopy in the VUH SK (Vilnius, Lithuania) be tween 2009 and 2012. Results A total of 1633 colonoscopies, which were performed by five practicing endoscopists were included. The overall cecal intu bation rate was 96.8%. Bowel preparation was good, medium and poor in 65.2%, 28.1% and 6.7% cases, respectively. Polyps were found more commonly in men rather than women: adenomas 40.4% vs. 24% (p<0.001), hyperplastic polyps 11.1% vs. 6.6% (p=0.001), multiple adenomas 6.4% vs. 1.9% (p<0.001). Colorectal cancer was found in 76 patients (4.7%) and there was no statistically significant difference regarding sex (p=0.76). The overall ADR was 31.5%. ADR in men was statistically signifi cantly higher compared with ADR in women (40.4% vs. 24%; p<0.001). ADR ranged among endoscopists from 26.8% to 36.5% (p=0.007). Overall multiple adenoma detection rate was 4% and ranged among endoscopists from 1.7% to 6.7% (p=0.03). Mean number of adenoma per procedure was 0.5 and mean number of adenoma per positive procedure was 1.59. 51Adenoma detection rate for screening colonoscopy: one center experience ConclusionsAdenoma detection rate in our center is high. Based on current recommendations ADR detected is sufficient for reporting high quality screening colonoscopy. Key words: adenoma, adenomatous polyps, colon, colonoscopy, detection, colorectal neoplasms Įvadas Prevencinių kolonoskopijų kokybė vertinama apskaičiuojant adenomų radimo dažį (ARD). Mūsų tyrimo tikslas -apskaičiuoti prevencinių kolonoskopijų (storosios žarnos vėžio ankstyvosios diagnostikos programa) ARD ir kitus išvestinius kokybės ro diklius bei palyginti jų skirtumus tarp Vilniaus universiteto ligoninės Santariškių klinikų endoskopuotojų (VUL SK). Metodai Retrospektyvusis 2009-2012 metais VUL SK (Vilnius, Lietuva) atliktų prevencinių kolonoskopijų duomenų tyrimas. Rezultatai Į analizę buvo įtrauktos 1633 kolonoskopijos, kurias atliko 5 endoskopuotojai. Bendras aklosios žarnos intubacijos dažnis buvo 96,8%. Žarnynas tyrimui buvo paruoštas gerai 65,2% atvejų, vidutiniškai 28,1 % atvejų ir blogai 6,7 % atvejų. Polipai dažniau rasti vyrams nei moterims: adenomos 40,4 % vs. 24 % (p<0,001), hiperplaziniai polipai 11,1 % vs. 6,6 % (p=0,001), daugybinės adenomos 6,4 % vs. 1,9 % (p<0,001). Storosios žarnos vėžys buvo rastas 76 pacientams (4,6 %) ir statistiškai reikšmingai nesiskyrė tarp vyrų ir moterų grupių (p=0,76). Bendras ARD buvo 31,5 % ir jis statistiškai reikšmingai buvo dides nis vyrų nei moterų grupėje: 40,4 % vs. 24 % (p<0,001). Tarp endoskopuotojų ARD svyravo nuo 26,8 % iki 36,5 % (p=0,007). Bendras daugybinių adenomų radimo dažnis buvo 4 % ir tarp endoskopuotojų svyravo nuo 1,7 %...

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Section: Discussionsupporting

confidence: 92%

“…In clinical practice, the ADR was also found to be closely associated with the quality of bowel preparation, the cecal intubation rate, the level of operating techniques of the endoscopist and the quality of the endoscopic devices [17]. Noting that, the present study had certain limitations.…”

Section: Discussionmentioning

confidence: 65%

Adenomų radimo dažnis atliekant prevencines kolonoskopijas: vieno centro patirtis

Pilvinytė¹,

Mašalaitė²,

Stanaitis³

2017

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“…In addition, the polyp and adenoma detection rates used in many studies are from screening colonoscopies only, while we used our entire database, not looking at the indication due to the very low prevalence of screening colonoscopies in our database. Some of the factors described in the literature for higher polyp detection rates were confirmed in our study, such as male gender or age ≥ 65 years and the dubious contribution of sedation [23,24] . Consequently, we can answer the question if a global objective for polyp detection in colonoscopy is possible, regardless of the indication, since every colonoscopy offers a therapeutic opportunity.…”

Section: Discussionsupporting

confidence: 82%

Quality in Colonoscopy: Beyond the Adenoma Detection Rate Fever

Taveira

Areia

Elvas

et al. 2017

GE Port J Gastroenterol

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Background: Colonoscopy quality is a hot topic in gastroenterological communities, with several actual guidelines focusing on this aspect. Although the adenoma detection rate (ADR) is the single most important indicator, several other metrics are described and need reporting. Electronic medical reports are essential for the audit of quality indicators; nevertheless, they have proved not to be faultless. Aim: The aim of this study was to analyse and audit quality indicators (apart from ADR) using only our internal electronic endoscopy records as a starting point for improvement. Methods: An analysis of electronically recorded information of 8,851 total colonoscopies from a single tertiary centre from 2010 to 2015 was performed. Results: The mean patient age was 63.4 ± 8.5 years; 45.5% of them were female, and in 14.6% sedation was used. Photographic documentation was done in 98.4% with 10.7 photographs on average, and 37.4% reports had <8 pictures per exam. Bowel preparation was rated as adequate in 67%, fair in 27% and inadequate in 4.9% of cases. The adjusted caecal intubation rate (CIR) was 92%, while negative predictors were inadequate preparation (OR 119, 95% CI 84-170), no sedation (OR 2.39, 95% CI 1.81-3.15), female gender (OR 1.61, 95% CI 1.38-1.88) and age ≥65 years (OR 1.56, 95% CI 1.34-1.82). In 28% of patients, a snare polypectomy was performed, correlating with adequate preparation (OR 5.75, 95% CI 3.90-8.48), male gender (OR 1.82, 95% CI 1.64-2.01) and age ≥65 years (OR 1.25, 95% CI 1.13-1.37; p < 0.01) as positive predictors. An annual evolution was observed with improvements in photographic documentation (10.7 vs. 12.9; p < 0.001), CIR (91 vs. 94%; p = 0.002) and “adequate” bowel preparation (p = 0.004). Conclusions: There is much more to report than the ADR to ensure quality in colonoscopy practice. Better registry systematization and integrated software should be goals to achieve in the short term.

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“…Several studies on ADR have been previously conducted. A nationwide survey of 3,266 patients in France reported an ADR of 17.7% (578/3,266), whereas the ADR of male patients was significantly higher compared with that of female patients (21.2 vs. 14.5%, respectively; P<0.0001); furthermore, the ADR of patients aged >50 years was significantly higher compared with that of patients aged <50 years (20.6 vs. 8.5%, respectively; P<0.0001) (4). Another French study reported an ADR of 31% (5).…”

Section: Introductionmentioning

confidence: 92%

Adenoma detection rate in 41,010 patients from Southwest China

Cai

Liu

et al. 2015

Oncology Letters

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Abstract. Adenoma detection rate (ADR) is considered as an important predictor of the risk of interval colorectal cancer following a screening colonoscopy. A retrospective review of all the patients who underwent colonoscopy in the First Affiliated Hospital of Guangxi Medical University (Nanning, China) between 2003 and 2012 was performed, with the aim of estimating the ADR in Southwest China and determine the effects of age, gender and polyp location on ADR. Demographic information and data regarding the timing of the colonoscopy, number of polyps removed, polyp location and pathological types of polyps were collected and analyzed. The patients were grouped according to colonoscopy date, polyp location, gender and age. The χ 2 test was used to compare the ADR between the different age and gender groups and the Cochran-Armitage trend test was used to calculate the statistical significance of the ADR trend across age groups. A two-tailed value of P<0.05 was considered to indicate statistically significant differences. A total of 41,010 patients were included, of whom 7,219 were diagnosed with at least one adenoma on pathological examination. Therefore, the ADR value of the 41,010 patients screened in the present study was 17.6%. There was a statistically significant trend of increasing ADR with increasing age in both genders (P<0.05). In addition, the ADR of male patients was significantly higher compared with that of female patients in all age groups (all P<0.05). The ADR of patients aged >50 years was significantly higher compared with that of patients aged <50 years (28.8 vs. 11.0%, respectively; P<0.05). In addition, 20% of the cases of detected adenomas occurred in the rectum, 47% in the left colon and 33% in the right colon.

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Factors Associated with Adenoma Detection Rate and Diagnosis of Polyps and Colorectal Cancer during Colonoscopy in France: Results of a Prospective, Nationwide Survey

Cited by 48 publications

References 27 publications

Adenomų radimo dažnis atliekant prevencines kolonoskopijas: vieno centro patirtis

Adenomų radimo dažnis atliekant prevencines kolonoskopijas: vieno centro patirtis

Quality in Colonoscopy: Beyond the Adenoma Detection Rate Fever

Adenoma detection rate in 41,010 patients from Southwest China

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