Does trainee participation during colonoscopy affect adenoma detection rates?

Area of Science:

• Gastroenterology
• Medical Education
• Endoscopy

Background:

• Colonoscopy is crucial for colorectal cancer screening and diagnosis.
• Training new endoscopists is vital to meet rising healthcare demands.
• The effect of trainee participation on adenoma detection rates (ADR) is not well-established.

Purpose of the Study:

• To evaluate if adenoma detection rates differ in colonoscopies performed with or without trainee involvement.
• To compare advanced adenoma detection rates between procedures with and without trainees.
• To assess the impact of trainee participation on procedure time.

Main Methods:

• Prospective, single-center study.
• Involved 368 consecutive patients undergoing colonoscopy.
• Compared ADR in 181 procedures with trainee participation versus 187 without.

Main Results:

• Adenomas detected in 19.3% of physician-only procedures vs. 14.9% with trainees.
• Advanced adenomas detected in 8.6% of physician-only procedures vs. 4.9% with trainees.
• Polyp detection rates were similar (32% vs. 33%), and procedures with trainees were delayed by ~7 minutes.

Conclusions:

• Adenoma detection rates were not significantly different between procedures with or without trainee involvement.
• A trend towards lower adenoma and advanced adenoma detection in trainee procedures was observed but within interobserver variability.
• Similar polyp detection suggests trainees may remove more hyperplastic polyps, not missing adenomas.