Background
Current guidelines suggest screening adenoma detection rates (ADRs) of 15% for average-risk
women and 25% for average-risk men.
Objective
Determine average-risk screening ADRs and the prevalence of adenomas by location,
size, shape, and degree of dysplasia in each sex.
Design
Post hoc analysis of prospectively collected data.
Setting
Academic center, ambulatory center.
Patients
A total of 864 average-risk patients.
Intervention
Screening colonoscopy.
Main Outcome Measurements
By using a prospectively collected colonoscopy database, we determined the ADRs for
each sex and compared them to current medical society guidelines. In patients with
adenomas detected, we compared the percentage of proximally located, large, and advanced-pathology
adenomas between sexes.
Results
The overall average-risk screening ADR was 33.7% for both sexes combined. Average
risks for women and men were significantly higher than guidelines (women: 25.4% vs
15%; P = .0003; men: 41.2% vs 25%; P < .0001). The ADR remained significantly higher for men versus women (P < .0001). Overall advanced-pathology adenoma detection was 12.2% for both sexes combined.
There was a significantly higher advanced-pathology ADR for men (15.3%) versus women
(8.7%) (P = .003). There was no significant difference between the sexes when age was considered
in both advanced-pathology and average-risk ADRs.
Limitations
Data from the study focused on improving ADRs in an academic setting.
Conclusion
The ADR in our study was higher than current benchmarks for both sexes. In patients
with at least one adenoma, advanced-pathology adenomas were detected equally among
men and women. Although the benefits of achieving supra-benchmark ADRs are unknown,
high ADRs may lead to more effective colonoscopy.
Abbreviations:
ADR (adenoma detection rate), CRC (colorectal cancer), EQUIP (endoscopist quality improvement program)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 04, 2013
Accepted:
December 1,
2012
Received:
October 2,
2012
Footnotes
DISCLOSURE: M. Wallace received research funding from Olympus America, but not for this study. No other financial relationships relevant to this publication were disclosed.
Identification
Copyright
© 2013 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
