Khushboo Gala, MD, Mohamed Elmasry, DO, Wenjing Cai, MD, Scott Diamond, MD, Amal Shine, MD, David Liu, MD, Nanlong Liu, MD, Don Ramesh Tholkage, MD, Maiying Kong, PhD, Craig McClain, MD, Dipendra Parajuli, MD; University of Louisville, Louisville, KY
Introduction: Clinically Significant Serrated Polyp Detection Rate (CSSDR) and Proximal Serrated Polyp Detection Rate (PSDR) have been suggested as potential new benchmarks to prevent colorectal cancer (CRC) (CSSDR = 7% and PSDR = 11%), in addition to Adenoma Detection Rate (ADR) (ADR = 25% overall, 30% in men, and 20% in women). CSSDR is defined as a serrated adenoma or hyperplastic polyp ≥1cm anywhere in the colon or any hyperplastic polyp ≥ 5mm proximal to the sigmoid, whereas PSDR is any serrated polyp of any size proximal to the sigmoid colon. We evaluated CSSDR, PSDR and ADR and the patient factors that were associated with them in colonoscopies performed by gastrointestinal (GI) medicine fellows. Methods: A retrospective review of 795 patient colonoscopy reports was performed. Demographic data, details of GI fellows and pathology found on colonoscopy were recorded. Continuous variables were summarized using median values and interquartile ranges, and categorical variables were summarized using frequencies and percentages. Multiple linear regression analysis was performed between groups. Results: For our patient population, median age was 58 years, 396 (49.8%) were male, 368 (46.3%) Caucasian, and 386 (48.6%) African American. There were 15 performing fellows, ranging from first year (F1) to third year (F3) of training. We found a CSSDR of 4.4%, PSDR of 10.5% and ADR of 42.1% (48.6% in males, 36.7% in females) in our practice. Using logistic regression modelling, we found that BMI (OR = 1.1290, p = 0.013), female gender (OR = 2.1655, p = 0.042) and age (OR = 1.3632, p = 0.092, significant at 10% level of significance) were significantly associated with the CSSDR. In comparison, only age was significantly associated with the PSDR (OR = 1.3437, p = 0.015). Discussion: Although GI fellows demonstrated an above-recommended ADR during colonoscopy and nearly reached target PSDR, they failed to achieve target CSSDR. This suggests that trainees may not be detecting serrated polyps at a target rate, and require supervision and targeted education. Patient factors like BMI, age and gender affect CSSDR and ADR, and the effects of patient characteristics on these newer benchmarks need to be further explored.
Disclosures: Khushboo Gala indicated no relevant financial relationships. Mohamed Elmasry indicated no relevant financial relationships. Wenjing Cai indicated no relevant financial relationships. Scott Diamond indicated no relevant financial relationships. Amal Shine indicated no relevant financial relationships. David Liu indicated no relevant financial relationships. Nanlong Liu indicated no relevant financial relationships. Don Ramesh Tholkage indicated no relevant financial relationships. Maiying Kong indicated no relevant financial relationships. Craig McClain indicated no relevant financial relationships. Dipendra Parajuli indicated no relevant financial relationships.