Adenoma Detection Rates: Does Endoscopic Volume or Provider Specialty Matter More?

Background: Adenoma detection rate (ADR) is a well-established quality indicator for colonoscopy. Previous studies have demonstrated a superior ADR for gastroenterologists versus non-gastroenterologists. However, the number of annual colonoscopies performed by non-gastroenterologists in these studies has been variable and often far fewer than the number performed by gastroenterologists. Our study aims to compare ADR in gastroenterologists and specifically colorectal surgeons of comparable colonoscopy volumes at a single institution. Methods: A retrospective chart review of all screening colonoscopies for average-risk patients was performed at a single tertiary care facility, including colonoscopies performed by both gastroenterologists and colorectal surgeons. Univariate analysis was performed using GraphPad Prism v9.3.0. Results: No significant difference in overall adenoma detection rates (ADR) was appreciated between gastroenterologists and colorectal surgeons at our institution (36.3% (SD 12.3%) vs. 30.8% (SD 6.7%), respectively, p = 0.224). Colorectal surgeons were more likely to have a longer withdrawal time (15.20 min vs. 11.17 min). Gastroenterologists were more likely to collect any specimen during colonoscopy (40.4% vs. 53.6%). However, there was no statistically significant difference in ADR when comparing the top five highest volume colorectal surgeons and the top five highest volume gastroenterologists, and both high-volume groups met recognized benchmarks for male, female, and overall ADR (30%, 20%, 25%). Conclusions: Colorectal surgeons removed a similar number of tubulovillous adenomas compared to gastroenterologists. Gastroenterologists tend to remove more polyps overall, including more hyperplastic polyps and sessile serrated adenomas. Despite this, no significant difference in ADR was identified between high-volume colorectal surgeons and gastroenterologists.