Association of Adenoma and Proximal Sessile Serrated Polyp Detection Rates With Endoscopist Characteristics

Area of Science:

• Gastroenterology
• Endoscopy
• Colorectal Cancer Screening

Background:

• Adenoma detection rate (ADR) and proximal sessile serrated polyp detection rate (pSSPDR) are key quality indicators in colonoscopy.
• Previous studies suggest endoscopist characteristics influence ADR and pSSPDR, but often without adjusting for confounding factors.

Purpose of the Study:

• To evaluate the association between endoscopist characteristics and polyp detection rates (ADR and pSSPDR).
• To adjust for patient and colonoscopy-related factors in assessing these associations.

Main Methods:

• A cohort study of 16,089 screening colonoscopies performed between January 2015 and June 2017.
• Multilevel mixed-effects logistic regression analysis examining 7 endoscopist characteristics.
• Control for patient demographics, clinical factors, and colonoscopy-associated factors.

Main Results:

• Adenoma detection rate (ADR) was not significantly associated with any endoscopist characteristics.
• Proximal sessile serrated polyp detection rate (pSSPDR) was significantly associated with more years in practice and higher annual colonoscopy volume.
• Surgeons and non-gastroenterologists showed reduced pSSPDR in initial analysis, but this was not replicated in the adjusted model.

Conclusions:

• Endoscopist characteristics like sex and specialty are not reliable predictors of ADR or pSSPDR after adjusting for confounders.
• Years in practice and colonoscopy volume are associated with pSSPDR, indicating potential areas for quality improvement and targeted training.
• These findings suggest that patient choice of endoscopist based on non-clinical characteristics may not be beneficial for colorectal cancer screening quality.