Adenoma and Polyp Detection Rates in Colonoscopy according to Indication

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 c...

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Main Authors: Erika S. Boroff, Molly Disbrow, Michael D. Crowell, Francisco C. Ramirez
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2017/7207595
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author Erika S. Boroff
Molly Disbrow
Michael D. Crowell
Francisco C. Ramirez
author_facet Erika S. Boroff
Molly Disbrow
Michael D. Crowell
Francisco C. Ramirez
author_sort Erika S. Boroff
collection DOAJ
description 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.
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spelling doaj-art-fde71fa60bfd4e72b35a00ea18db08092025-08-20T02:22:34ZengWileyGastroenterology Research and Practice1687-61211687-630X2017-01-01201710.1155/2017/72075957207595Adenoma and Polyp Detection Rates in Colonoscopy according to IndicationErika S. Boroff0Molly Disbrow1Michael D. Crowell2Francisco C. Ramirez3Division of Gastroenterology, Mayo Clinic, Scottsdale, AZ, USADepartment of Medicine, Mayo Clinic, Scottsdale, AZ, USADivision of Gastroenterology, Mayo Clinic, Scottsdale, AZ, USADivision of Gastroenterology, Mayo Clinic, Scottsdale, AZ, USABackground. 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.http://dx.doi.org/10.1155/2017/7207595
spellingShingle Erika S. Boroff
Molly Disbrow
Michael D. Crowell
Francisco C. Ramirez
Adenoma and Polyp Detection Rates in Colonoscopy according to Indication
Gastroenterology Research and Practice
title Adenoma and Polyp Detection Rates in Colonoscopy according to Indication
title_full Adenoma and Polyp Detection Rates in Colonoscopy according to Indication
title_fullStr Adenoma and Polyp Detection Rates in Colonoscopy according to Indication
title_full_unstemmed Adenoma and Polyp Detection Rates in Colonoscopy according to Indication
title_short Adenoma and Polyp Detection Rates in Colonoscopy according to Indication
title_sort adenoma and polyp detection rates in colonoscopy according to indication
url http://dx.doi.org/10.1155/2017/7207595
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AT mollydisbrow adenomaandpolypdetectionratesincolonoscopyaccordingtoindication
AT michaeldcrowell adenomaandpolypdetectionratesincolonoscopyaccordingtoindication
AT franciscocramirez adenomaandpolypdetectionratesincolonoscopyaccordingtoindication