Download PDF
CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(04): E534-E538
DOI: 10.1055/a-1784-0313
Original article

Effect of a polyp detection poster on detection of sessile serrated lesions: a prospective controlled study

Aasma Shaukat
1   Division of Gastroenterology, NYU Grossman School of Medicine, New York, New York, United States
2   Division of Gastroenterology, University of Minnesota System, Minneapolis, Minnesota, United States
,
Douglas K. Rex
3   Department of Medicine, Division of Gastroenterology, Indiana University, Indianapolis, Indiana, United States
,
Michael Shyne
4   Department of Biostatistics, University of Minnesota System, Minneapolis, Minnesota, United States
,
Timothy R. Church
5   Department of Environmental Health, University of Minnesota System, Minneapolis, Minnesota, United States
,
Joseph P. Moscatelli
6   Department of Biology, Middlebury College, Middlebury, Vermont, United States
,
Joshua B. Colton
7   MNGI Digestive Health P.A St. Paul Minnesota, United States
› Author AffiliationsSupported by: ACG Institute for Clinical Research and Education CR001
› Further Information
Also available at
   Permissions and Reprints

Abstract

Background and study aims Colonoscopy is effective in reducing the incidence of colorectal cancer, but interval cancers remain a concern and their occurrence mainly is thought to be due to poor detection of sessile serrated lesions (SSLs) and advanced neoplasia (AN). Currently there are no low-cost, easy-to-implement tools to improve detection of difficult-to-detect polyps. Our aims were to compare the detection rate for SSLs and AN between two groups of endoscopists at a large community practice, one of which received an intervention of a polyp detection poster displayed over the monitor in their endoscopy suite for 6 months. We compared preintervention and post-intervention detection rates in the intervention and control groups.

Methods This was a convenience case control quality improvement project. For 6 months, a 2’ × 3’ poster of pictures of SSLs and advanced neoplasia was displayed over the monitor for 44 endoscopist in a large community gastroenterology practice in the Minneapolis/St.Paul area, while another 44 physicians performed colonoscopy in the usual fashion without the poster. The endpoints were improvement in detection rates for SSLs and AN preintervention and post-intervention between the control and intervention groups.

Results During the study, 88 endoscopists performed 54,861 colonoscopies. At least one adenoma was detected in 41.3 % of patients, one or more SSLs in 11.4 %, and AN in 10.6 %. During the intervention period, the SSL detection rates were 10.9 % and 12.3 % for the control and intervention groups and for AN, the detection rates were 10.4 % and 10.75 % for the two groups, respectively. Exposure to the polyp detection poster significantly changed SSL detection for the intervention group relative to the control group (likelihood ratio test P < 0.001). No significant effect of the intervention was observed for detection of AN, right-sided AN or left-sided AN, or adenoma detection rate.

Conclusions Placement of a polyp detection poster above the endoscopy video monitor increased detection of SSL but not AN.



Publication History

Received: 19 August 2021

Accepted after revision: 03 December 2021

Article published online:
14 April 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Kahi CJ, Hewett DG, Norton DL. et al. Prevalence and variable detection of proximal colon serrated polyps during screening colonoscopy. Clin Gastroenterol Hepatol 2011; 9: 42-46
    CrossrefPubMedGoogle Scholar
  • 2 Rex DK, Petrini JL, Baron TH. et al. Quality indicators for colonoscopy. Am J Gastroenterol 2006; 101: 873-885
    CrossrefPubMedGoogle Scholar
  • 3 Shaukat A, Oancea C, Bond JH. et al. Variation in detection of adenomas and polyps by colonoscopy and change over time with a performance improvement program. Clin Gastroenterol Hepatol 2009; 7: 1335-1340
    CrossrefPubMedGoogle Scholar
  • 4 Kaminski MF, Regula J, Kraszewska E. et al. Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med 2010; 362: 1795-1803
    CrossrefPubMedGoogle Scholar
  • 5 Corley DA, Jensen CD, Marks AR. et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med 2014; 370: 1298-1306
    CrossrefPubMedGoogle Scholar
  • 6 Shaukat A, Shamsi N, Menk J. et al. Polyp sizing poster improves polyp measurement but not adenoma detection rates by endoscopists in a large community practice. Clin Gastroenterol Hepatol 2019; 17: 2034-2041
    CrossrefPubMedGoogle Scholar
  • 7 Dolan P, Hallsworth M, Halpen D. The mindspace way. J Econ Psychol 2012; 33: 264-277
    CrossrefPubMedGoogle Scholar
  • 8 Gupta S, Lieberman D, Anderson JC. et al. Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol 2020; 115: 415-434
    CrossrefPubMedGoogle Scholar
  • 9 Rex DK, Ahnen DJ, Baron JA. et al. Serrated lesions of the colorectum: review and recommendations from an expert panel. Am J Gastroenterol 2012; 107: 1315-1329
    CrossrefPubMedGoogle Scholar
  • 10 Thaler RH, Sunstein CR. Nudge: Improving Decisions about health wealth and Happiness. London: Penguin Books; 2009
    Google Scholar