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Factors Associated with Surveillance Adenoma and Sessile Serrated Polyp Detection Rates

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Abstract

Background

Adenoma detection rate (ADR) and sessile serrated polyp detection rate (SSPDR) data in surveillance colonoscopy are limited.

Aims

Our aim was to determine surveillance ADR and SSPDR and identify associated predictors.

Methods

A retrospective review of subjects who underwent surveillance colonoscopy for adenoma and/or SSP at an academic center was performed. The following exclusion criteria were applied: prior colonoscopy ≤ 3 years, incomplete examination, or another indication for colonoscopy. Patient, endoscopist, and procedure characteristics were collected. Predictors were identified using multivariable logistic regression.

Results

Of 3807 colonoscopies, 2416 met inclusion criteria. Surveillance ADR was 49% and, SSPDR was 8%. Higher ADR was associated with: age per year (OR 1.03; 95% CI 1.02–1.04), male gender (OR 1.55; 95% CI 1.29–1.88), BMI per kg/m2 (OR 1.02; 95% CI 1.01–1.04), withdrawal time per minute (OR 1.09; 95% CI 1.07–1.10), and endoscopists’ screening ADR (OR 1.01; 95% CI 1.00–1.03). Years since training (OR 0.99; 95% CI 0.98–0.99) was associated with lower ADR. Family history of CRC (OR 1.58; 95% CI 1.02–2.27) and endoscopists’ screening ADR (OR 1.40; 95% CI 1.15–1.74) were associated with higher SSPDR. African-American race (OR 0.36; 95% CI 0.10–0.75) and diabetes (OR 0.41; 95% CI 0.21–0.76) were associated with lower SSPDR.

Conclusions

For surveillance colonoscopy, nearly half of patients had an adenoma and one in twelve had an SSP. In addition to established factors, BMI, endoscopists’ screening ADR, and years since training were associated with ADR, whereas African-American race and diabetes were inversely associated with SSPDR. Further studies are needed prior to integrating surveillance ADR and SSPDR into quality metrics.

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Abbreviations

ADR:

Adenoma detection rate

BMI:

Body mass index

CI:

Confidence interval

CRC:

Colorectal cancer

FH:

Family history

OR:

Odds ratio

SD:

Standard deviation

SSP:

Sessile serrated polyp

SSPDR:

Sessile serrated polyp detection rate

US:

United States

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Author information

Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Michigan Medicine, 3912 Taubman Center, SPC 5362, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-5362, USA

    Jennifer K. Maratt, Grace H. Elta, Kenya Jackson, Christine Erickson & Stacy B. Menees

  2. University of Michigan, Ann Arbor, MI, USA

    Joseph Dickens & Daniel Rizk

  3. John D. Dingell Veterans Affairs Medical Center, Detroit, MI, USA

    Philip S. Schoenfeld

  4. Veterans Administration Ann Arbor Healthcare System, Ann Arbor, MI, USA

    Jennifer K. Maratt & Stacy B. Menees

Authors
  1. Jennifer K. Maratt
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  3. Philip S. Schoenfeld
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  4. Grace H. Elta
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  5. Kenya Jackson
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Contributions

Stacy Menees, Joseph Dickens, and Jennifer Maratt had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. SM was involved in study concept and design. SM, JD, JM, DR, CE, and KJ were involved in acquisition, analysis, or interpretation of data. JM, JD, and SM were involved in drafting of the manuscript. All authors were involved in critical revision of the manuscript for important intellectual content. JD, SM, JM, and KJ were involved in statistical analysis. SM was involved in study supervision.

Corresponding author

Correspondence to Jennifer K. Maratt.

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Conflict of interest

Grace Elta has been a consultant for Olympus Medical. Philip Schoenfeld has been a consultant, a member of the advisory board, and on the speaker bureau for Ironwood Pharmaceuticals, Allergan Pharmaceuticals, Salix Pharmaceuticals, and a consultant and member of the advisory board for Synergy Pharmaceuticals. All other authors have no conflicts of interest to report.

Ethical Approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this retrospective study, formal consent was not required. This article does not contain any studies with animals performed by any of the authors.

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Maratt, J.K., Dickens, J., Schoenfeld, P.S. et al. Factors Associated with Surveillance Adenoma and Sessile Serrated Polyp Detection Rates. Dig Dis Sci 62, 3579–3585 (2017). https://doi.org/10.1007/s10620-017-4792-7

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  • DOI: https://doi.org/10.1007/s10620-017-4792-7

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