scholarly journals Adenoma and Polyp Detection Rates in Colonoscopy according to Indication

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Erika S. Boroff ◽  
Molly Disbrow ◽  
Michael D. Crowell ◽  
Francisco C. Ramirez
Keyword(s):  
Distal Colon ◽  
Proximal Colon ◽  
Screening Colonoscopy ◽  
Bowel Habit ◽  
Polyp Detection ◽  
Age And Gender ◽  
Detection Rates ◽  
Adenoma Detection ◽  
And Gender ◽  
Colon Data

Background. Adenoma detection rate (ADR) is a validated quality measure for screening colonoscopy, but there are little data for other indications. The distribution of adenomas is not well described for these indications. Aim. To describe ADR and the adenoma distribution in the proximal and distal colon based on colonoscopy indication. Methods. Outpatient colonoscopies are subdivided by indication. PDR and ADR for the entire colon and for proximal and distal colon. Data were compared using generalized estimating equations to adjust for clustering amongst endoscopists while controlling for patient age and gender. Results. 3436 colonoscopies were reviewed (51.2%: men (n=1759)). Indications are screening 49.2%, surveillance 29.3%, change in bowel habit 8.4%, bleeding 5.8%, colitides 3.0%, pain 2.8%, and miscellaneous 1.5%. Overall ADR was 37% proximal ADR 28%, and distal ADR 17%. PDR and ADR were significantly higher in surveillance than in screening (PDR: 69% versus 51%; ADR: 50% versus 33%; p=0.0001). Adenomas were more often detected in the proximal than in the distal colon, for all indications. Conclusions. Prevalence of polyps and adenomas differs based on colonoscopy indication. Adenoma detection is highest in surveillance and more commonly detected in the proximal colon. For quality assurance, distinct ADR and PDR targets may need to be established for different colonoscopy indications.

scholarly journals Expert endoscopists with high adenoma detection rates frequently detect diminutive adenomas in proximal colon

2020 ◽  
Vol 08 (06) ◽  
pp. E775-E782
Author(s):  
Osamu Toyoshima ◽  
Toshihiro Nishizawa ◽  
Shuntaro Yoshida ◽  
Kazuma Sekiba ◽  
Yosuke Kataoka ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Detection Rate ◽  
Patient Characteristics ◽  
Proximal Colon ◽  
Polyp Detection ◽  
Detection Rates ◽  
Serrated Polyps ◽  
Adenoma Detection ◽  
Important Quality

Abstract Background and study aims Adenoma detection rate (ADR) is an important quality indicator in colonoscopy, and improved ADR decreases the incidence of colorectal cancer. We investigated differences in polyp detection according to the endoscopist’s ADR. Patients and methods We performed a propensity-score matching study using baseline patient characteristics of age, sex, body mass index, family history of colorectal cancer, smoking, drinking, indication for colonoscopy, bowel preparation, and colonoscope type. We compared polyp detection and colonoscopy procedures between patients who underwent colonoscopy by high-ADR endoscopists (high ADR group) and by low-ADR endoscopists (low ADR group). Results We matched 334 patients in the high ADR group with 334 in the low ADR group. The ADR was 44.0 % and 26.9 % for the high-ADR and low-ADR endoscopists, respectively. Proximal, nonprotruding, and diminutive adenomas were more frequently detected by high-ADR endoscopists than by low-ADR endoscopists (all P < 0.001); similarly, more high-risk adenomas were detected by high-ADR endoscopists (P = 0.028). Furthermore, more sessile serrated polyps detected by high-ADR endoscopists (P = 0.041). High-ADR endoscopists more frequently performed pancolonic chromoendoscopy (P < 0.001). Conclusions Expert detectors often found nonprotruding and diminutive adenomas in the proximal colon along with increased detection rate of high-risk adenomas. Low-ADR endoscopists need to recognize the features of missed adenomas to improve their ADRs.

scholarly journals Impact of real-time use of artificial intelligence in improving adenoma detection during colonoscopy: A systematic review and meta-analysis

2021 ◽  
Vol 09 (04) ◽  
pp. E513-E521
Author(s):  
Munish Ashat ◽  
Jagpal Singh Klair ◽  
Dhruv Singh ◽  
Arvind Rangarajan Murali ◽  
Rajesh Krishnamoorthi
Keyword(s):  
Artificial Intelligence ◽  
Systematic Review ◽  
Meta Analysis ◽  
Screening Colonoscopy ◽  
Average Risk ◽  
Polyp Detection ◽  
Withdrawal Time ◽  
Detection Rates ◽  
Adenoma Detection ◽  
The Impact

Abstract Background and study aims With the advent of deep neural networks (DNN) learning, the field of artificial intelligence (AI) is rapidly evolving. Recent randomized controlled trials (RCT) have investigated the influence of integrating AI in colonoscopy and its impact on adenoma detection rates (ADRs) and polyp detection rates (PDRs). We performed a systematic review and meta-analysis to reliably assess if the impact is statistically significant enough to warrant the adoption of AI -assisted colonoscopy (AIAC) in clinical practice. Methods We conducted a comprehensive search of multiple electronic databases and conference proceedings to identify RCTs that compared outcomes between AIAC and conventional colonoscopy (CC). The primary outcome was ADR. The secondary outcomes were PDR and total withdrawal time (WT). Results Six RCTs (comparing AIAC vs CC) with 5058 individuals undergoing average-risk screening colonoscopy were included in the meta-analysis. ADR was significantly higher with AIAC compared to CC (33.7 % versus 22.9 %; odds ratio (OR) 1.76, 95 % confidence interval (CI) 1.55–2.00; I2 = 28 %). Similarly, PDR was significantly higher with AIAC (45.6 % versus 30.6 %; OR 1.90, 95 %CI, 1.68–2.15, I2 = 0 %). The overall WT was higher for AIAC compared to CC (mean difference [MD] 0.46 (0.00–0.92) minutes, I2 = 94 %). Conclusions There is an increase in adenoma and polyp detection with the utilization of AIAC.

scholarly journals Adenoma Detection before and after the age of 50: a retrospective analysis of Lebanese outpatients

2018 ◽  
Vol 5 (1) ◽  
pp. e000253 ◽  
Author(s):  
Mohammed Hussein Kamareddine ◽  
Youssef Ghosn ◽  
Karam Karam ◽  
Anwar Andrew Nader ◽  
Ahmad El-Mahmoud ◽  
...  
Keyword(s):  
Age Groups ◽  
Adenomatous Polyps ◽  
Screening Colonoscopy ◽  
International Studies ◽  
Detection Rates ◽  
Adenoma Detection ◽  
Before And After ◽  
Male Patients ◽  
And Gender ◽  
Gender Detection

Background and aimColorectal cancer (CRC) has an increased impact on the Lebanese population’s morbidity and mortality. This study evaluated the situation of adenoma detection in an outpatient clinic in Lebanon.Patients and methods918 patients underwent colonoscopy over a period of 24 months by a qualified physician. Biopsy results were divided into normal versus abnormal colonic tissue, which was further subdivided into number of polyps and cancer.ResultsOut of 918 individuals included, 82 cases of Crohn’s colitis (8.93%) and 22 cases of ulcerative colitis (2.39%) were identified. A total of 42 cases of CRC (4.58%) and 188 cases of adenomatous polyps (20.48%) were identified. The data show that age >50 years and male gender significantly correlate with increased incidence of precancerous and cancerous polyps. Further exploring the results by age groups and gender, detection of adenomatous polyps in women aged 40–49 (8.33%) was significantly different from their female counterparts aged ≥50 years old (25.26%) (p<0.01). However, no statistical difference between detection of adenomas was found between men aged 40–49 (33.33%) and their male counterparts aged ≥50 years old (37.5%) (p=0.6).ConclusionWithin the limitations of this study, the incidence of CRC and adenomatous polyps falls in the high range compared with international studies. Furthermore, symptomatic male patients aged 40–49 appear to exhibit detection rates of adenomas similar to their counterparts aged ≥50 years old. Subjects younger than 50 years underwent diagnostic rather than screening colonoscopy, which introduces some selection bias. Nevertheless, these findings can serve as a basis for further studies.

G-EYE advanced colonoscopy for improved polyp detection rates – a randomized tandem pilot study with different endoscopists

2018 ◽  
Vol 56 (05) ◽  
pp. 488-494 ◽  
Author(s):  
Sebastian Dümcke ◽  
Jafer Haschemi ◽  
Achim Tresch ◽  
Dietmar Borger ◽  
Ann-Christin Kirchner ◽  
...  
Keyword(s):  
Detection Rate ◽  
Screening Colonoscopy ◽  
Polyp Detection ◽  
Detection Rates ◽  
Adenoma Detection ◽  
Group A ◽  
Baseline Characteristics ◽  
Level Of Training ◽  
Group B ◽  
Standard Colonoscopy

Abstract Background and aims The most commonly missed polyps in colonoscopy are those located behind haustral folds. The G-EYE system is a standard colonoscope consisting of re-processable balloon at its distal tip. The G-EYE balloon improves the detection of polyps by straightening the haustral folds. In our back-to-back tandem study, we aimed to determine whether and to what extent the G-EYE system could reduce adenoma miss rates in screening colonoscopy. Methods Patients referred to colonoscopy were randomized into 2 groups. Group A underwent a standard colonoscopy (SC) followed by balloon colonoscopy (BC), and Group B underwent BC followed by SC. In this randomized tandem study, the investigator’s level of training and the endoscopists themselves were changed after each withdrawal. Each endoscopist was blinded to the results of the first withdrawal. Results Fifty-eight patients were enrolled and randomized into 2 groups with similar baseline characteristics. Nine patients were excluded from the study. Twenty-five patients underwent SC followed by BC while 24 underwent BC followed by SC. The adenoma miss rate for SC was 41 %, with an additional detection rate of 69 % for BC (ratio 1.69). The overall miss rate for polyps was 60 % for SC, with an additional detection rate of 150 % for BC (ratio 2.5). Experienced investigators who used BC were able to identify an additional 7 polyps while inexperienced investigators. Conclusions Although our results could not clearly confirm that BC improves adenoma detection, the investigator’s experience appears to be a major determinant of the adenoma detection rate.

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

2018 ◽  
Vol 06 (11) ◽  
pp. E1304-E1309
Author(s):  
Julio F. León Moreno
Keyword(s):  
Screening Colonoscopy ◽  
Health Clinic ◽  
Cecal Intubation ◽  
Patient Age ◽  
Tertiary Referral Center ◽  
Patient Âgé ◽  
Adenoma Detection ◽  
And Gender ◽  
American Society ◽  
Colonoscopy Quality

Abstract Background and study aims High-quality colonoscopy is fundamental for preventing colorectal cancer (CRC). The adenoma detection rate (ADR) is a key colonoscopy quality measure. The aim of this study was to establish the screening colonoscopy ADR of a tertiary referral center in Peru, identify the relationship between the ADR and patient age, sex and the colonoscopist, and determine the endoscopic and histopathological characteristics of the lesions found. Patients and methods A retrospective observational longitudinal study was undertaken between January 2016 and June 2017. Results Eight colonoscopists performed screening colonoscopies on 620 patients scoring ≥ 6 points on the Boston Bowel Preparation Scale (BBPS); cecal intubation was complete in 595 patients (cecal intubation rate [CIR] 95.9 %). The overall ADR was 29.7 % (females 25.4 %, males 33.1 %, P = 0.040, 95 %Cl). The ADR colonoscopist range was 25.0 % to 34.4 %. The highest ADR (41.2 %, P = 0.013, 95 %Cl) was for patients aged 65 to 75 years. Adenoma colon locations were: left 49 %, transverse 21.6 % and right 29.4 %. Adenoma dysplasia grades: low 98 %, high 2 %. Sixty-three percent of the lesions were 5 mm to 10 mm. Resections performed: 78.5 % cold biopsy forceps (CBF), 3.4 % cold snare polypectomy (CSP) and 18.1 % endoscopic mucosal resection (EMR). Conclusions The ADR established was in line with the joint American College of Gastroenterology (ACG)/American Society for Gastrointestinal Endoscopy (ASGE) recommendations and related to patient age and gender but not to the colonoscopist. Colonoscopists should ensure rigorous application of the colonoscopy quality actions. ADR should be evaluated frequently.

scholarly journals Factors Affecting Proximal Colon Cleansing Based on Bowel Movement Kinetics: A Prospective Observational Study

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Dae Bum Kim ◽  
Kang-Moon Lee ◽  
Sung-Goo Kang ◽  
Sung Hoon Jung
Keyword(s):  
Waist Circumference ◽  
Bowel Preparation ◽  
Female Gender ◽  
Distal Colon ◽  
Proximal Colon ◽  
Screening Colonoscopy ◽  
Factors Affecting ◽  
Colon Cleansing ◽  
Fair Poor

Background. Previous studies have suggested that relatively poor bowel preparation in the proximal colon, compared to that in the distal colon, could decrease the usefulness of colonoscopy. The aim of this study was to determine whether the “first defecation time” after polyethylene glycol (PEG) administration affects the cleansing quality in the proximal colon. Methods. A total of 425 individuals who were scheduled to undergo a screening colonoscopy were enrolled prospectively at the healthcare center of St. Vincent’s Hospital, Suwon, Korea, between April 2015 and March 2016. Bowel cleansing was performed using 4 L of PEG. Surveys were conducted to obtain information regarding the “first defecation time.” Endoscopists assessed the quality of bowel preparation in each bowel segment. Results. We investigated 425 consecutive eligible cases. The mean “first defecation time” after PEG administration was 54.35 min. The quality of bowel preparation was poorer in the proximal colon than that in the distal colon. The adequate (excellent, good) and inadequate (fair, poor) proximal colon preparation groups comprised 360 (84.7%) and 65 (15.3%) patients, respectively. A multivariate analysis revealed that female gender (P=0.029), small waist circumference (P=0.027), and the long “first defecation time” (P=0.034) were independently associated with inadequate bowel preparation in the proximal colon. Conclusion. Our data document that the “first defecation time,” female gender, and a small waist circumference affect the quality of preparation in the proximal colon. Inadequate preparation in the proximal colon was more common in females. Patients with these factors undergoing colonoscopy should be monitored carefully.

The effect of periodic monitoring and feedback on screening colonoscopy withdrawal times, polyp detection rates, and patient satisfaction scores

2010 ◽  
Vol 71 (7) ◽  
pp. 1253-1259 ◽  
Author(s):  
Otto S. Lin ◽  
Richard A. Kozarek ◽  
Andrew Arai ◽  
Michael Gluck ◽  
Geoffrey C. Jiranek ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Screening Colonoscopy ◽  
Polyp Detection ◽  
Detection Rates ◽  
Patient Satisfaction Scores ◽  
Periodic Monitoring
Sign in / Sign up

Export Citation Format

Share Document