Korean J Gastroenterol.  2014 Jul;64(1):18-23. 10.4166/kjg.2014.64.1.18.

Correlation between Adenoma Detection Rate and Advanced Adenoma Detection Rate

• Lee SY
• Kim NH
• Chae HB
• Han KJ
• Lee TH
• Jang CM
• Yoo KM
• Jung YS
• Park JH
• Kim HJ
• Cho YK
• Sohn CI
• Jeon WK
• Kim BI
• Park DI

• KMID: 1791890
• DOI: http://doi.org/10.4166/kjg.2014.64.1.18

Abstract

BACKGROUND/AIMS
Adenoma detection rate (ADR) is widely used as an index of colonoscopy quality management. Although advanced adenomas can be found less frequently than non-advanced adenomas, advanced adenomas have a higher clinical significance during screening for colorectal cancer. The aim of this study was to investigate the correlation between advanced and non-advanced ADR among colonoscopists.
METHODS
This study is an observational study of a cohort of patients undergoing screening colonoscopy between 2009 and 2010. We collected the data on patients' characteristics and colonoscopic findings. The detection rates of adenoma and advanced adenoma were calculated. Logistic regression was used to determine the effects of variables on advanced adenoma detection, and spearman's rank-order correlation was used to evaluate the relationship between advanced ADR and ADR.
RESULTS
A total of 561 patients underwent screening colonoscopy by 18 experienced colonoscopists. Most colonoscopists had adequate (>20%) ADRs. Logistic regression showed that increased patient age (OR 1.07 per 1 year increase, 95% CI 1.009-1.133, p=0.023) and male gender (OR 1.860, 95% CI 0.764-4.529, p=0.171) were associated with advanced ADR. When colonoscopists were divided into two groups on the basis of advanced ADR of 5%, ADR was also significantly higher in the group having higher level of advanced ADR. However, there was no correlation between advanced ADR and ADR among colonoscopists as an individual.
CONCLUSIONS
Colonoscopists' advanced ADRs were independent of their ADRs, indicating that advanced ADR could be quite low even among colonoscopists with acceptable ADRs. Thus, there seems to be a limitation in using ADR as an adequate index of colonoscopy quality management.

Keyword

Adenoma; Colonoscopy; Colorectal neoplasms; Early detection of cancer

MeSH Terms

Adenoma/*diagnosis
Adult
Aged
Cohort Studies
Colonoscopy
Colorectal Neoplasms/*diagnosis
Early Detection of Cancer
Female
Humans
Logistic Models
Male
Middle Aged
Neoplasm Staging
Odds Ratio

Figure

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  Fig. 1. Study enrollment. a Performed ＜10 colonoscopies during the study period.

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  Fig. 2. Adenoma detection rate (ADR) vs. advanced ADR for all colonoscopists.

Reference

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