Adenoma Detection Rate in Colonoscopy: Is Indication a Predictor?

Area of Science:

• Gastroenterology
• Endoscopy
• Colorectal Cancer Screening

Background:

• Adenoma detection rate (ADR) is a key quality indicator in colonoscopy.
• Understanding factors influencing ADR is crucial for improving colorectal cancer (CRC) detection.
• Colonoscopy indications significantly impact the diagnostic yield.

Purpose of the Study:

• To investigate the influence of colonoscopy indications on adenoma detection rate (ADR).
• To compare ADR across different screening, surveillance, and diagnostic colonoscopy groups.

Main Methods:

• Retrospective analysis of 2648 consecutive colonoscopies performed by a single endoscopist (2008-2014).
• Colonoscopy indications were analyzed for association with ADR, adjusting for patient age and sex.

Main Results:

• Overall ADR was 22.9% for screening colonoscopies.
• Fecal occult blood test-triggered screening colonoscopies had a higher ADR (32%) compared to family history (21.7%) or asymptomatic average-risk (20.4%) indications (P=0.05).
• Surveillance colonoscopies showed the highest ADR (36.1%), while diagnostic colonoscopies for gastrointestinal symptoms ranged from 12% to 30%.

Conclusions:

• Colonoscopy indication is a significant determinant of adenoma detection rate.
• Screening colonoscopies prompted by positive fecal occult blood tests demonstrate a higher ADR, suggesting increased adenoma prevalence in this subgroup.