Endoscopist specialty is associated with colonoscopy quality

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Health Services Research

Background:

• Endoscopist specialty may influence colorectal cancer detection rates.
• Polypectomy rate is a key indicator of colonoscopy quality.
• Understanding factors affecting polypectomy rates is crucial for improving cancer screening.

Purpose of the Study:

• To investigate the association between endoscopist specialty (surgeons vs. gastroenterologists) and polypectomy rates.
• To assess if endoscopist specialty impacts colonoscopy quality indicators.

Main Methods:

• Cross-sectional study of 2,651 patients (aged 50-75) undergoing colonoscopy in Montreal and Calgary.
• Data collected via patient questionnaires and provincial health administrative databases.
• Bayesian hierarchical logistic regression analyzed the odds of polypectomy by endoscopist specialty, adjusting for patient-level covariates.

Main Results:

• In Montreal, surgeons had an adjusted odds ratio of 0.48 (95% CI: 0.32-0.71) for polypectomy compared to gastroenterologists.
• In Calgary, the adjusted odds ratio for surgeons was 0.73 (95% CI: 0.43-1.21), indicating a non-significant association.
• The study included 2,113 colonoscopies from Montreal and 538 from Calgary.

Conclusions:

• An association between endoscopist specialty and polypectomy rates was observed in both cities.
• Montreal data suggest surgeons are less likely to perform polypectomies than gastroenterologists.
• Further research is needed to address potential residual confounding and confirm findings.