Endoscopy 2023; 55(05): 434-441
DOI: 10.1055/a-1974-9979
Original article

Comparison of adenoma detection rate and proximal serrated polyp detection rate and their effect on post-colonoscopy colorectal cancer mortality in screening patients

Jasmin Zessner-Spitzenberg
1   Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
2   Quality Assurance Working Group, Austrian Society of Gastroenterology and Hepatology, Vienna, Austria
,
Elisabeth Waldmann
1   Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
2   Quality Assurance Working Group, Austrian Society of Gastroenterology and Hepatology, Vienna, Austria
,
Lena Jiricka
3   Center for Medical Statistics, Informatics and Intelligent Systems, Institute of Clinical Biometrics, Medical University of Vienna, Vienna, Austria
,
Lisa-Maria Rockenbauer
1   Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
2   Quality Assurance Working Group, Austrian Society of Gastroenterology and Hepatology, Vienna, Austria
,
Anna Hinterberger
1   Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
2   Quality Assurance Working Group, Austrian Society of Gastroenterology and Hepatology, Vienna, Austria
,
Jeremy Cook
1   Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
2   Quality Assurance Working Group, Austrian Society of Gastroenterology and Hepatology, Vienna, Austria
,
Arno Asaturi
1   Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
2   Quality Assurance Working Group, Austrian Society of Gastroenterology and Hepatology, Vienna, Austria
,
Aleksandra Szymanska
1   Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
2   Quality Assurance Working Group, Austrian Society of Gastroenterology and Hepatology, Vienna, Austria
,
Barbara Majcher
1   Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
2   Quality Assurance Working Group, Austrian Society of Gastroenterology and Hepatology, Vienna, Austria
,
Michael Trauner
1   Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
,
Monika Ferlitsch
1   Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
2   Quality Assurance Working Group, Austrian Society of Gastroenterology and Hepatology, Vienna, Austria
› Author AffiliationsAustrian Main Association of Statutory Insurance Institutions Austrian Cancer Aid Österreichische Gesellschaft für Gastroenterologie und Hepatologie http://dx.doi.org/10.13039 /501100020617
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Referred to by:

Author commentary on Jasmin Zessner-Spitzenberg et al.Endoscopy 2023; 55(05): v12-v12
DOI: 10.1055/a-1965-8446

Referred to by:

Proximal serrated polyp detection rate and post-colonoscopy colorectal cancer: the missing linkEndoscopy 2023; 55(05): 442-443
DOI: 10.1055/a-2003-1068

Abstract

Background Patients with serrated polyps are at increased risk for post-colonoscopy colorectal cancer (PCCRC); however, evidence for a dedicated serrated polyp detection rate is lacking. The aim of this study was to investigate the association of the proximal serrated polyp detection rate (PSDR) and adenoma detection rate (ADR) with PCCRC death.

Methods This was a retrospective analysis within the Austrian quality assurance program for screening colonoscopy. Spearman’s rank coefficient was calculated for the assessment of association between ADR and PSDR. Whether ADR or PSDR were associated with colorectal cancer mortality was assessed by Cox proportional hazards model.

Results 229/729 screening colonoscopies performed by 308 endoscopists were analyzed. The ADR (hazard ratio [HR] per 1 percentage point increase 0.98, 95 %CI 0.96–0.99) as well as the PSDR (HR per 1 percentage point increase 0.97, 95 %CI 0.94–0.99) were significantly associated with PCCRC death. The correlation coefficient of the ADR and PSDR calculated at every colonoscopy was 0.70 (95 %CI 0.70–0.71), and the corresponding PSDR value for an ADR performance standard of 25 % was 11.1 %. At the end of the study period, 86 endoscopists (27.9 %) reached an ADR of > 25 % and a PSDR of > 11.1 %.

Conclusions The ADR as well as the PSDR were associated with PCCRC death. Striving for a high PSDR in addition to a high ADR might reduce the risk for PCCRC mortality in patients undergoing screening colonoscopy.

Supplementary material



Publication History

Received: 22 February 2022

Accepted after revision: 12 October 2022

Article published online:
08 December 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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