Inter-centre variability of the adenoma detection rate: a prospective, multicentre study
Enrico Ricci1, Cesare Hassan, Lucio Petruzziello
1Department of Gastroenterology, G. B. Morgagni Hospital, Forlì, Italy.
Summary
Colonoscopy quality varies significantly between centers, impacting cancer detection rates. Measuring center-specific neoplasia detection can improve colonoscopy performance and reduce interval cancer risk.
Area of Science:
- Gastroenterology
- Endoscopy
- Public Health
Background:
- Suboptimal colonoscopy quality increases the risk of interval colorectal cancer.
- Variability in neoplasia detection rates among endoscopy centers is a concern.
Purpose of the Study:
- To investigate the variability in neoplasia detection rates across different endoscopic centers in an unselected population.
- To identify factors influencing these detection rates.
Main Methods:
- A study involving 3150 consecutive patients undergoing colonoscopy across 28 Italian centers.
- Assessment of polyp, neoplasia, and advanced neoplasia detection rates at individual and center levels.
- Multivariate analysis to adjust for patient-related factors and explore inter-center variability.
Main Results:
- Median detection rates were 35% for polyps, 26% for neoplasia, and 13% for advanced neoplasia.
- Patient factors like age, sex, alcohol, and smoking history influenced detection.
- Significant inter-center variability in neoplasia detection persisted even after adjusting for patient factors and withdrawal time.
Conclusions:
- A wide variability exists in neoplasia and advanced neoplasia detection rates among endoscopic centers.
- Center-related neoplasia detection rates could serve as a valuable performance indicator for colonoscopy quality.