Colonoscopy scheduling influences adenoma and polyp detection rates

Area of Science:

• Gastroenterology
• Endoscopy
• Preventive Medicine

Background:

• Endoscopist fatigue can affect colonoscopy performance.
• Procedural fatigue may increase as the day progresses.

Purpose of the Study:

• To investigate the impact of colonoscopy scheduling on adenoma detection rates (ADR) and polyp detection rates (PDR).

Main Methods:

• Retrospective analysis of prospectively collected data from 1,293 asymptomatic, average-risk patients.
• Assessment of procedure timing: morning vs. afternoon, start times, and hourly intervals.
• Multivariable analysis to identify factors associated with ADR and PDR.

Main Results:

• Morning colonoscopies showed significantly higher ADR (42.3%) and PDR (52.5%) compared to afternoon procedures (34.7% ADR, 46.3% PDR).
• Afternoon colonoscopies were associated with a decreased ADR (OR, 0.739; p=0.018).
• Colonoscopies performed during the fourth hour of a session also showed a decreased ADR (OR, 0.651; p=0.029).

Conclusions:

• Scheduling colonoscopies in the morning improves ADR and PDR.
• Later procedure times, particularly the fourth hour, are linked to reduced ADR.
• Optimizing colonoscopy scheduling may enhance adenoma and polyp detection efficacy.