Background
The frequency of nonneoplastic polypectomy (NNP) and its impact on the polyp detection
rate (PDR) is unknown. The correlation between NNP and adenoma detection rate (ADR)
and its impact on the cost of colonoscopy has not been investigated.
Objective
To determine the rate of NNP in screening colonoscopy, the impact of NNP on the PDR,
and the correlation of NNP with ADR. The increased cost of NNP during screening colonoscopy
also was calculated.
Design
We reviewed all screening colonoscopies. PDR and ADR were calculated. We then calculated
a nonneoplastic polyp detection rate (patients with ≥1 nonneoplastic polyp).
Setting
Tertiary-care referral center.
Patients
Patients who underwent screening colonoscopies from 2010 to 2011.
Interventions
Colonoscopy.
Main Outcome Measurements
ADR, PDR, NNP rate.
Results
A total of 1797 colonoscopies were reviewed. Mean (± standard deviation) PDR was 47.7%
± 12.0%, and mean ADR was 27.3% ± 6.9%. The overall NNP rate was 10.4% ± 7.1%, with
a range of 2.4% to 28.4%. Among all polypectomies (n = 2061), 276 were for nonneoplastic
polyps (13.4%). Endoscopists with a higher rate of nonneoplastic polyp detection were
more likely to detect an adenoma (odds ratio 1.58; 95% confidence interval, 1.1-1.2).
With one outlier excluded, there was a strong correlation between ADR and NNP (r = 0.825; P < .001). The increased cost of removal of nonneoplastic polyps was $32,963.
Limitations
Retrospective study.
Conclusion
There is a strong correlation between adenoma detection and nonneoplastic polyp detection.
The etiology is unclear, but nonneoplastic polyp detection rate may inflate the PDR
for some endoscopists. NNP also adds an increased cost. Increasing the awareness of
endoscopic appearances through advanced imaging techniques of normal versus neoplastic
tissue may be an area to improve cost containment in screening colonoscopy.
Abbreviations:
ADR (adenoma detection rate), ASGE (American Society for Gastrointestinal Endoscopy), NNP (nonneoplastic polypectomy), PDR (polyp detection rate)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 02, 2015
Accepted:
January 4,
2015
Received:
July 3,
2014
Footnotes
DISCLOSURE: All authors disclosed no financial relationships relevant to this article.
If you would like to chat with an author of this article, you may contact Dr Ramirez at [email protected]
Identification
Copyright
© 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
