Year 2019 / Volume 111 / Number 8
Original
Relationship between the polyp detection rate and the post-colonoscopy colorectal cancer rate

598-602

DOI: 10.17235/reed.2019.5889/2018

Violeta María Sastre Lozano, Senador Morán Sánchez, José García Solano, Pablo Conesa Zamora, Guadalupe Ruiz Merino,

Abstract
Aim: the adenoma detection rate is the quality indicator of colonoscopy that is most closely related to the development of interval colorectal cancer or post-colonoscopy colorectal cancer. However, the recording of this indicator in different units of gastrointestinal endoscopy is obstructed due to the large consumption of resources required for its calculation. Several alternatives have been proposed, such as the polyp detection rate. The objective of this study was to evaluate the relationship between the polyp detection rate and its influence on post-colonoscopy colorectal cancer rate. Patients and methods: in this study, 12,482 colonoscopies conducted by 14 endoscopists were analyzed. The polyp detection rate was calculated for each endoscopist. Endoscopists were grouped into quartiles (Q1, Q2, Q3, and Q4), from lowest to highest polyp detection rate, in order to evaluate whether there were any differences in the development of post-colonoscopy colorectal cancer. Results: the lowest polyp detection rate was 20.66% and the highest was 52.16%, with a median of 32.78 and a standard deviation of ± 8.54. A strong and positive association between polyp endoscopy diagnosis and adenoma histopathology result was observed and a linear regression was performed. A significantly higher post-colonoscopy colorectal cancer rate was observed in the group of endoscopists with a lower polyp detection rate (p < 0.02). Conclusion: polyp detection rate is a valuable quality indicator of colonoscopy and its calculation is much simpler than that of the adenoma detection rate. In our study, the prevalence of post-colonoscopy colorectal cancer was inversely and significantly related to the endoscopists’ polyp detection rate.
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References
REFERENCES:
1. National Cancer Institute [Internet]. Available from: https://seer.cancer.gov/statfacts/html/colorect.html.
2. O. Hosokawa, S. Shirasaki, Y. Kaizaki, et al., Invasive Colorectal Cancer Detected up to 3 Years after a Colonoscopy Negative for Cancer. Endoscopy, 2003. 35(6): p. 506-510.
3. Ferrandez, A., Navarro, M., Díez, M., et al., Risk factors for advanced lesions undetected at prior colonoscopy: not always poor preparation. Endoscopy, 2010. 42(12): p. 1071-1076.
4. Adler, J. and D.J. Robertson, Interval Colorectal Cancer After Colonoscopy: Exploring Explanations and Solutions. Am J Gastroenterol, 2015. 110(12): p. 1657-1664; quiz 1665.
5. Murino, A., C. Hassan, and A. Repici, The diminutive colon polyp: biopsy, snare, leave alone? Curr Opin Gastroenterol, 2016. 32(1): p. 38-43.
6. Pohl, H., Srivastava, A., Bensen, S.P., et al., Incomplete polyp resection during colonoscopy-results of the complete adenoma resection (CARE) study. Gastroenterology, 2013. 144(1): p. 74-80 e1.
7. Cha, J.M., Colonoscopy Quality is the Answer for the Emerging Issue of Interval Cancer. Intest Res, 2014. 12(2): p. 110-116.
8. Pabby A, S.R., Weissfeld JL, et al., Analysis of colorectal cancer occurrence during surveillance colonoscopy in the dietary Polyp Prevention Trial. Gastrointest Endosc, 2005. 61: p. 385-391.
9. Robertson, D.J., Lieberman, D.A., Winawer, S.J., et al., Colorectal cancers soon after colonoscopy: a pooled multicohort analysis. Gut, 2014. 63(6): p. 949-956.
10. Rutter, M.D., Senore, C., Bisschops, R., et al., The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures. Endoscopy, 2016. 48(1): p. 81-89.
11. Corley, D.A., Jensen, C.D., Marks, A.R., et al., Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med, 2014. 370(14): p. 1298-1306.
12. Francis, D.L., Rodríguez Correa, D.T., Buchner, A., et al., Application of a conversion factor to estimate the adenoma detection rate from the polyp detection rate. Gastrointest Endosc, 2011. 73(3): p. 493-497.
13. Williams, J.E., J.L. Holub, and D.O. Faigel, Polypectomy rate is a valid quality measure for colonoscopy: results from a national endoscopy database. Gastrointest Endosc, 2012. 75(3): p. 576-582.
14. Dominitz, J.A. and D.J. Robertson, Interval cancers: learning from the past as we build for the future. Am J Gastroenterol, 2013. 108(8): p. 1341-1343.
15. Shaukat, A., Arain, M., Thaygarajan, B., et al., Is BRAF mutation associated with interval colorectal cancers? Dig Dis Sci, 2010. 55(8): p. 2352-2356.
16. Ruiz, L.M., Colonoscopias de vigilancia: riesgo de neoplasia colorrectal. Gastroenterología y Hepatología, 2013. 36: p. 80-85.
17. Singh, S., Singh, P.P., Murad, M.H., et al., Prevalence, risk factors, and outcomes of interval colorectal cancers: a systematic review and meta-analysis. Am J Gastroenterol, 2014. 109(9): p. 1375-1389.
18. Xiang, L., Zhan, Q., Zhao, X.H., et al., Risk factors associated with missed colorectal flat adenoma: a multicenter retrospective tandem colonoscopy study. World J Gastroenterol, 2014. 20(31): p. 10927-10937.
19. Winawer, S.J., Zauber, A.G., Fletcher, R.H., et al., Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. Gastroenterology, 2006. 130(6): p. 1872-1885.
20. Rex, D.K., Colonoscopic withdrawal technique is associated with adenoma miss rates. Gastrointest Endosc, 2000. 51(1): p. 33-36.
21. Jover, R., Zapater, P., Bujanda, L., et al., Endoscopist characteristics that influence the quality of colonoscopy. Endoscopy, 2016. 48(3): p. 241-247.
22. Kaminski, M.F., Regula, J., Kraszeuska, E., et al., Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med, 2010. 362(19): p. 1795-1803.23.
23. Rex, D.K., et al., Quality indicators for colonoscopy. Gastrointest Endosc, 2015. 81(1): p. 31-53.
24. van Doorn, S.C., Van Vliet, J., Fockens, P., et al., A novel colonoscopy reporting system enabling quality assurance. Endoscopy, 2014. 46(3): p. 181-187.
25. Baxter, N.N., Sutradhar, R., Forbes, S.S., et al., Analysis of administrative data finds endoscopist quality measures associated with postcolonoscopy colorectal cancer. Gastroenterology, 2011. 140(1): p. 65-72.
26. Morris, E.J., et al., Post-colonoscopy colorectal cancer (PCCRC) rates vary considerably depending on the method used to calculate them: a retrospective observational population-based study of PCCRC in the English National Health Service. Gut, 2015. 64(8): p. 1248-56.
27. Ruiz-Rebollo, M.L., et al., Aetiology and prevalence of post-colonoscopy colorrectal cancer. Gastroenterol Hepatol, 2016.
28. Munoz Garcia-Borruel, M., et al., Post-colonoscopy colorectal cancer: Characteristics and predictive factors. Med Clin (Barc), 2017.
29. Lieberman, D. and R. Mascarenhas, Adenoma detection rate: in search of quality improvement, not just measurement. Gastrointest Endosc, 2015. 82(4): p. 683-685.
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Sastre Lozano V, Morán Sánchez S, García Solano J, Conesa Zamora P, Ruiz Merino G. Relationship between the polyp detection rate and the post-colonoscopy colorectal cancer rate. 5889/2018


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Publication history

Received: 28/08/2018

Accepted: 04/02/2019

Online First: 13/06/2019

Published: 31/07/2019

Article revision time: 154 days

Article Online First time: 289 days

Article editing time: 337 days


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