Shaman Dalal, MD
Cleveland, Ohio
Shaman Dalal, MD1, Aun Shah, MD1, Patrick Twohig, MD, MPH2, Aakash Desai, MD3, Dalbir S. Sandhu, MD1
1Case Western Reserve University / MetroHealth Medical Center, Cleveland, OH; 2MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH; 3MetroHealth Hospital, Case Western Reserve University, Cleveland, OH
Introduction:
Adenoma detection rate (ADR) benchmark of >25% has been shown to reduce interval colorectal cancer (CRC). S
errated polyp detection rate (SDR) and advanced adenoma detection rate (AADR) can also serve as additional benchmarks to reduce interval CRC,
although a standardized benchmark for AADR and SDR doesn’t exist. Recent studies have shown correlation between ADR, SDR and AADR, but in a homogenous patient population. Our study evaluated the correlation between ADR, SDR and AADR and approximated a benchmark for SDR and AADR in a diverse urban population, while attempting to identify any patient variables affecting detection rates.
Methods:
We reviewed screening colonoscopies performed at our midwest urban, safety-net health care system over a period of one year (2017). We calculated ADR, SDR and AADR for individual providers and established correlation using non-parametric Spearman correlation coefficients between the 3 entities. Logistic regression analysis was used to calculate predictors of adenomas, advanced adenomas and serrated polyps.
Results: Of the 3000 colonoscopies reviewed, 1488 were screening colonoscopies performed by 9 experienced staff gastroenterologists. The patient population included 48% African-Americans, 42% Caucasians, and 10% others. Median (Interquartile range) ADR of all providers was 42.5 (27-61), SDR 8.4 (3.6-23), and AADR was 2.9 (0.6-4.8). All providers had an overall ADR above 25%. There was a weak positive correlation for ADR and SDR (rho=0.13), and ADR and AADR (rho=0.13). Logistic regression analysis identified male gender (p< 0.01) and body mass index (p=0.02) as predictors of adenomas, while longer withdrawal time was a significant predictor for all types of polyps. We did not find statistical significance for gender or body mass index and SDR.
Discussion:
Based on our study, previously suggested benchmark SDR of 7% seems appropriate. Our AADR of 2.9 was lower than suggested AADR of >6%. Additionally, a weak positive correlation was noted between ADR and SDR, and ADR with AADR although the patient population was heterogeneous and diverse making the results more generalizable for the real world.
Citation: Shaman Dalal, MD; Aun Shah, MD; Patrick Twohig, MD, MPH; Aakash Desai, MD; Dalbir S. Sandhu, MD. P2032 - CAN ADENOMA DETECTION RATES PREDICT A BENCHMARK FOR SERRATED POLYP AND ADVANCED ADENOMA DETECTION RATES IN A DIVERSE URBAN POPULATION?. Program No. P2032. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.