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Monitoring colonoscopy screening program quality at the provider level, the institution level, and beyond

Published:November 09, 2022DOI:https://doi.org/10.1016/j.gie.2022.08.044
      This year marks the twentieth anniversary since the U.S. Multi-Society Task Force on Colorectal Cancer issued benchmarking standards for adenoma detection rates (ADRs) in screening colonoscopy cohorts.
      • Rex D.K.
      • Bond J.H.
      • Winawer S.
      • et al.
      Quality in the technical performance of colonoscopy and the continuous quality improvement process for colonoscopy: recommendations of the U.S. Multi-Society Task Force on Colorectal Cancer.
      It is now over a decade since the publication of prospective population-level data clearly described how increased ADR leads to the development of reduced rates of interval colorectal cancer (iCRC).
      • Kaminski M.F.
      • Regula J.
      • Kraszewska E.
      • et al.
      Quality indicators for colonoscopy and the risk of interval cancer.
      Subsequent studies showed that when colonoscopists improved their own personal ADR to >25%, a decline in their attributable iCRC followed.
      • Kaminski M.F.
      • Wieszczy P.
      • Rupinski M.
      • et al.
      Increased rate of adenoma detection associates with reduced risk of colorectal cancer and death.
      Additional studies showed that iCRC continued to decline, even at ADR levels >33.5%, so that for every 1% increase in the ADR there was an associated 3% reduction in CRC risk.
      • Corley D.A.
      • Jensen C.D.
      • Marks A.R.
      • et al.
      Adenoma detection rate and risk of colorectal cancer and death.

      Abbreviations:

      ADR (adenoma detection rate), iCRC (interval colorectal cancer), NLP (natural language processing)
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