Featured Research

from universities, journals, and other organizations

Variation In Polyp Detection Rates At Screening Colonoscopy

Date:
June 29, 2009
Source:
American Society for Gastrointestinal Endoscopy
Summary:
Colonoscopy is recommended as a primary screening method for colorectal cancer and is the final common pathway for all other recommended screening tests. It is considered the "gold standard" for colorectal cancer screening for its ability to diagnose and remove polyps (growths) before they turn into cancer. Colonoscopy uses a colonoscope, a tube with a light and video camera on the end, which allows the physician to see the entire colon.

Colonoscopy is recommended as a primary screening method for colorectal cancer and is the final common pathway for all other recommended screening tests. It is considered the "gold standard" for colorectal cancer screening for its ability to diagnose and remove polyps (growths) before they turn into cancer. Colonoscopy uses a colonoscope, a tube with a light and video camera on the end, which allows the physician to see the entire colon.

Related Articles


If a polyp is found, it can be removed immediately. The polyp is usually removed with small biopsy forceps or loop of wire (snare) that is advanced within a channel in the colonoscope.

Studies of screening colonoscopy have documented variation in adenoma (benign growth) detection rates between 10 percent and 50 percent. The clinical and medicolegal effects of missed lesions and the wide variation in polyp detection have created the need for quality standards for colonoscopy performance. The U.S. Multi-Society Task Force on Colorectal Cancer has established targets for continuous quality improvement. One such target is adenoma detection rates of 25 percent or greater for men and 15 percent or greater for women aged 50 years and older undergoing first-time screening colonoscopy. Another quality target is a mean minimum withdrawal time, currently suggested to be at least six minutes. With these targets in mind, researchers examined data from one of the longest ongoing programs of screening colonoscopy with the objectives of measuring the variation in polyp detection rates (PDRs) among endoscopists and identifying factors that account for the variation.

Researchers performed a retrospective cross-sectional analysis of summary-level data from endoscopists performing screening colonoscopy for the Lilly Colorectal Cancer Prevention Program in Indiana. All procedures were performed on average-risk, asymptomatic adults aged 50 years or older, who underwent first-time screening colonoscopy between September 1995 and June 2001. The study was approved by the institutional review board of Indiana University. The study included twenty-five endoscopists and 2,664 patients (1,108 women and 1,556 men). Summary-level data was analyzed for each endoscopist, including patient mean age, sex profile, mean procedure time, number of colonoscopies performed and the proportions of patients with any-sized polyp, any-sized adenoma, an adenoma one cm or larger in maximum diameter, and multiple (more than one) adenomas. Multiple linear regression analysis (a technique for determining the linear relationship between one dependent variable and two or more independent variables) identified factors that accounted for the variation in PDRs.

The mean procedure time (MPT) was 17.1 minutes. Adenoma detection rates ranged from seven percent to 44 percent and from zero percent to 13 percent for large polyps, which was not statistically significant. For all polyp categories, only one to three high outlier endoscopists (ie, higher than mean PDRs) were identified. Models that included the number of procedures, mean age, percentage of women, and MPT accounted for 36 percent to 56 percent of the variation in PDRs. Only MPT was significantly associated with PDRs across all models. Researchers concluded that PDRs vary widely among endoscopists, although only a few outliers (ie, endoscopists who had higher polyp detection rates) were identified, variation in PDRs was associated only with MPT and that further research is needed to determine the clinical importance of and reasons for this variation.

The researchers acknowledged several limitations including the use of summary-level data, which is more limited than individual data, indirect calculation of MPT, and whether each endoscopist's patient cohort was at comparable risk for colorectal neoplasia was uncertain.

In an accompanying editorial, Harminder Singh, MD, MPH, departments of internal medicine and community health sciences, University of Manitoba, Canada, and Gurkirpal Singh, MD, division of gasteroenterology and hepatology, Stanford University School of Medicine, Cal., stated that "whether the optimal withdrawal time to allow complete visualization of colonic mucosa for an average endoscopist should be six or 10 minutes or another time interval still needs to be better defined. Optimal withdrawal is essential to ensure complete colonic examination. Spending six or 10 minutes during withdrawal is a small price to pay for improving outcomes after colonoscopy."


Story Source:

The above story is based on materials provided by American Society for Gastrointestinal Endoscopy. Note: Materials may be edited for content and length.


Cite This Page:

American Society for Gastrointestinal Endoscopy. "Variation In Polyp Detection Rates At Screening Colonoscopy." ScienceDaily. ScienceDaily, 29 June 2009. <www.sciencedaily.com/releases/2009/06/090629132152.htm>.
American Society for Gastrointestinal Endoscopy. (2009, June 29). Variation In Polyp Detection Rates At Screening Colonoscopy. ScienceDaily. Retrieved October 24, 2014 from www.sciencedaily.com/releases/2009/06/090629132152.htm
American Society for Gastrointestinal Endoscopy. "Variation In Polyp Detection Rates At Screening Colonoscopy." ScienceDaily. www.sciencedaily.com/releases/2009/06/090629132152.htm (accessed October 24, 2014).

Share This



More Health & Medicine News

Friday, October 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

IKEA Desk Converts From Standing to Sitting With One Button

IKEA Desk Converts From Standing to Sitting With One Button

Buzz60 (Oct. 24, 2014) IKEA is out with a new convertible desk that can convert from a sitting desk to a standing one with just the push of a button. Jen Markham explains. Video provided by Buzz60
Powered by NewsLook.com
Ebola Protective Suits Being Made in China

Ebola Protective Suits Being Made in China

AFP (Oct. 24, 2014) A factory in China is busy making Ebola protective suits for healthcare workers and others fighting the spread of the virus. Duration: 00:38 Video provided by AFP
Powered by NewsLook.com
WHO: Millions of Ebola Vaccine Doses by 2015

WHO: Millions of Ebola Vaccine Doses by 2015

AP (Oct. 24, 2014) The World Health Organization said on Friday that millions of doses of two experimental Ebola vaccines could be ready for use in 2015 and five more experimental vaccines would start being tested in March. (Oct. 24) Video provided by AP
Powered by NewsLook.com
Doctor in NYC Quarantined With Ebola

Doctor in NYC Quarantined With Ebola

AP (Oct. 24, 2014) An emergency room doctor who recently returned to the city after treating Ebola patients in West Africa has tested positive for the virus. He's quarantined in a hospital. (Oct. 24) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins