Polyp detection rate: does length matter?

Polyp detection rate is a surrogate marker for adenoma detection rate and therefore a surrogate marker of quality colonoscopy. To our knowledge, this is the first study that compares distance from the monitor to the endoscopist on polyp detection rate.

This was a retrospective study comparing polyp detection rate across two different endoscopy room set-ups. All colonoscopies performed between December 2013 and November 2014 were retrieved. The difference in the room set-up was the distance from the endoscopist to the endoscopy monitor. Room A had a distance of 219 cm and Room B had 147 cm. We used two identical rooms, C and D, as a control arm with a distance of 190 cm between the endoscopist and the monitor.

There were significant differences in polyp detection rates between Room A and Room B in the bowel cancer screening lists. For these lists, the room with the closest distance from the endoscopist to the monitor (147 cm) had a statistically significant higher polyp detection rate than the room that had a further monitor to endoscopist distance of 219 cm (p<0.0006) and a trend towards a higher polyp detection rate compared with the room where the distance between the monitor and the endoscopist was 190 cm (p=0.08). This effect was not noticed across the service lists.

This study has suggested that the distance from the endoscopist to the monitor can affect polyp detection rate. It appears that for bowel cancer screening lists, the further the endoscopist from the monitor the lower their polyp detection rate.