Colonoscopists’ adenoma detection rates and risk of interval cancer

January 01, 0001

Colonoscopists’ adenoma detection rates and risk of interval cancer

These Polish authors assess the association between quality indicators for colonoscopy and the risk of interval cancer. Data were collected from 186 endoscopists who were involved in a colonoscopy-based colorectal-cancer screening program involving 45,026 subjects. Interval cancer was defined as colorectal adenocarcinoma that was diagnosed between the time of screening colonoscopy and the scheduled time of surveillance colonoscopy. They derived data on quality indicators for colonoscopy from the screening program's database and data on interval cancers from cancer registries.

They found: "A total of 42 interval colorectal cancers were identified during a period of 188,788 person-years. The endoscopist's rate of detection of adenomas was significantly associated with the risk of interval colorectal cancer, whereas the rate of cecal intubation was not significantly associated with this risk. The hazard ratios for adenoma detection rates of less than 11.0%, 11.0 to 14.9%, and 15.0 to 19.9%, as compared with a rate of 20.0% or higher, were 10.94, 10.75, and 12.50, respectively."

The authors concluded: "The adenoma detection rate is an independent predictor of the risk of interval colorectal cancer after screening colonoscopy."

Studies that seek to use this knowledge to improve outcomes are needed next.

For the full abstract, click here.

N Engl J Med 362(19):1795-1803, 13 May 2010
© 2010 to the Massachusetts Medical Society
Quality Indicators for Colonoscopy and the Risk of Interval Cancer. Michal F. Kaminski, Jaroslaw Regula, Ewa Kraszewska, et al. Correspondence to Dr. Regula:

Category: D. Digestive. Keywords: colonoscopy, colon cancer, screening, adenoma, detection rate, cohort study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 8 June 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.