Providing data for serrated polyp detection rate benchmarks: an analysis of the New Hampshire Colonoscopy Registry - 27/09/17
Abstract |
Background and Aims |
Similar to achieving adenoma detection rate (ADR) benchmarks to prevent colorectal cancer (CRC), achieving adequate serrated polyp detection rates (SDRs) may be essential to the prevention of CRC associated with the serrated pathway. Previous studies have been based on data from high-volume endoscopists at single academic centers. Based on a hypothesis that ADR is correlated with SDR, we stratified a large, diverse group of endoscopists (n = 77 practicing at 28 centers) into high performers and low performers, based on ADR, to provide data for corresponding target SDR benchmarks.
Methods |
By using colonoscopies in adults aged ≥50 years (4/09-12/14), we stratified endoscopists by high and low ADRs (<15%, 15%-<25%, 25%-<35%, ≥35%) to determine corresponding SDRs by using 2 SDR measures, for screening and surveillance colonoscopies separately: (1) Clinically significant SDR (CSSDR), meaning colonoscopies with any sessile serrated adenoma/polyp (SSA/P), traditional serrated adenoma (TSA), or hyperplastic polyp (HP) >1 cm anywhere in the colon or HP >5 mm in the proximal colon only divided by the total number of screening and surveillance colonoscopies, respectively. (2) Proximal SDR (PSDR) meaning colonoscopies with any serrated polyp (SSA/P, HP, TSA) of any size proximal to the sigmoid colon divided by the total number of screening and surveillance colonoscopies, respectively.
Results |
A total of 45,996 (29,960 screening) colonoscopies by 77 endoscopists (28 facilities) were included. Moderately strong positive correlation coefficients were observed for screening ADR/CSSDR (P = .69) and ADR/PSDR (P = .79) and a strong positive correlation (P = .82) for CSSDR/PSDR (P < .0001 for all) was observed. For ADR ≥25%, endoscopists’ median (interquartile range) screening CSSDR was 6.8% (4.3%-8.6%) and PSDR was 10.8% (8.6%-16.1%).
Conclusions |
Derived from ADR, the primary colonoscopy quality indicator, our results suggest potential SDR benchmarks (CSSDR = 7% and PSDR = 11%) that may guide adequate serrated polyp detection. Because CSSDR and PSDR are strongly correlated, endoscopists could use the simpler PSDR calculation to assess quality.
Le texte complet de cet article est disponible en PDF.Abbreviations : ACG, ADR, ASGE, CRC, HP, NHCR, NWT, SDR, SSA/P, TSA
Plan
| DISCLOSURE: This project was supported by grants R01CA131141 and 1R21CA191651 and contract HHSN261201400595P from the National Cancer Institute as well as by the Norris Cotton Cancer Center (L.F. Butterly). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. The contents of this work do not represent the views of the Department of Veterans Affairs or the U.S. government. All other authors disclosed no financial relationships relevant to this publication. |
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| See CME section; p. 1284. |
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| If you would like to chat with an author of this article, you may contact Dr Anderson at joseph.anderson@dartmouth.edu. |
Vol 85 - N° 6
P. 1188-1194 - juin 2017 Retour au numéro
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