Association between Colonoscopy Sedation Type and Polyp Detection: A Registry-based Cohort Study.

Area of Science:

• Gastroenterology
• Oncology
• Anesthesiology

Background:

• Colorectal cancer (CRC) is a significant cause of cancer mortality.
• Adenomas and serrated polyps are CRC precursors, with serrated polyps posing detection challenges during colonoscopy.
• The impact of propofol sedation on polyp detection requires further investigation.

Purpose of the Study:

• To investigate the association between propofol-based sedation and mild-to-moderate sedation on the detection of adenomas and serrated polyps during colonoscopy.
• To compare polyp detection rates between different sedation methods in a large patient cohort.

Main Methods:

• Retrospective cohort study utilizing data from the New Hampshire Colonoscopy Registry (2015-2020).
• Included patients over 50 undergoing screening/surveillance colonoscopies; excluded diagnostic exams, no sedation, missing data, or poor preparation.
• Multivariate logistic regression and propensity score adjustment were used to analyze polyp detection differences between propofol and moderate sedation.

Main Results:

• Analysis included 54,063 colonoscopies (full sample) and 18,998 (restricted sample).
• Propofol sedation was associated with significantly higher prevalence of serrated polyps in both samples.
• Multivariate analysis indicated propofol was linked to increased detection of neoplasms, adenomas, and serrated polyps in the full sample; effect attenuated but significant for serrated polyps in the restricted sample.

Conclusions:

• Propofol sedation may enhance the detection of serrated polyps during colonoscopy.
• No significant association was found between propofol use and adenoma detection.