Is there a "weekend effect" in adenoma detection rate?A single-center retrospective study

Area of Science:

• Gastroenterology
• Endoscopy
• Public Health

Background:

• The
• weekend effect
• (poorer outcomes on weekends) is observed in healthcare, but its impact on colonoscopy quality, specifically adenoma detection rate (ADR), is unclear.
• ADR is a crucial metric for predicting colorectal cancer risk.

Purpose of the Study:

• To investigate the existence of a weekend effect on ADR in a large colonoscopy cohort.
• To identify factors contributing to potential differences in ADR between weekend and weekday procedures.

Main Methods:

• A retrospective analysis of 16,550 colonoscopies performed between January 2022 and December 2023.
• Patients were grouped into Weekend (Saturday/Sunday) and Weekday (Monday-Friday) cohorts.
• Adenoma detection rate (ADR) was the primary outcome, with data on withdrawal time, bowel preparation (BBPS), and endoscopist experience analyzed using multivariable logistic regression.

Main Results:

• Weekend colonoscopies had a significantly lower ADR (24.1%) compared to weekdays (26.2%), with shorter median withdrawal times (3.61 vs. 4.59 minutes).
• Weekend procedures were independently associated with lower ADR (aOR 0.892), particularly affecting females, middle-aged patients (50-59), and those with inadequate bowel preparation.
• The weekend effect on ADR was primarily driven by junior endoscopists, with no significant difference observed for senior endoscopists.

Conclusions:

• A significant weekend effect on colonoscopy ADR exists, linked to shorter withdrawal times and concentrated among junior endoscopists.
• Quality improvement initiatives should focus on enforcing guideline-adherent withdrawal times, optimizing bowel preparation, and providing support to less-experienced endoscopists during weekend services.
• Standardizing colonoscopy quality across all days of the week is essential for consistent patient care and colorectal cancer prevention.