University of Illinois College of Medicine Peoria, IL
Saqib Walayat, MD1, Muhammad Baig, MD2, Srinivas Puli, MD2, Daniel Martin, MD2; 1University of Illinois College of Medicine, Peoria, IL; 2University of Illinois, Peoria, IL
Introduction: Colorectal cancer is one of the most common cancers all over the world. Colonoscopy remains the gold standard for screening of colorectal cancer. Adenoma detection rate remains a pivotal part of a high quality endoscopic exam. While various factors have been known to influence it, data regarding ideal screen distance for adenoma detection remains unclear. The aim of this study was to assess the rate of polyp detection and estimating size of diminutive (< 1 cm) polyps at 3, 6, and 9 feet. Methods: This was a quality improvement project carried out at OSF Saint Francis Medical center where post graduate trainees and attending physicians were enrolled. A 26-inch-high resolution screen was used and placed at eye level for the endoscopist. Fifty high resolution slides from our digital imaging storage software (Orpheus) of polyps (< 1 cm) intermixed with slides of normal colonic mucosa were included. These were shown to each endoscopist standing at 3, 6, and 9 feet on three separate days arranged in 3 different configurations. Polyp detection and sizes of polyps measured at various distances were recorded. Results: Seven subjects that included 3rd year Gastroenterology fellows and attendings were included in the study. 50 slides were included, 33 slides with polyps intermixed with slides of normal colonic mucosa. Results demonstrated that the number of polyps detected decreased as the distance from the screen increased. Mean number of polyps observed at 3 feet was 33.28, at 6 feet was 30.28, while at 9 feet mean polyp detection decreased to 26.14. Similarly, we noticed the estimate of polyp size to also decrease as the distance from the screen increased. Mean polyp size reported by all subjects at 3 feet was 1.94 mm, while at 6 feet it was 1.74 mm, and at 9 feet mean estimated polyp size was 1.55 mm. The participating subjects were surveyed verbally at the end of the study. They reported the highest level of comfort at 3 feet followed by 6 feet.
Discussion: Our study shed light on the importance of screen distance for polyp detection especially in case of smaller polyps. Our results suggest that the ideal screen distance for polyp detection should be close to 3 feet and ideally no more than 6 feet. Similarly, polyp size estimation is influenced inversely by screen distance with increasing distance from screen equating to smaller polyp size approximation. Larger studies are needed to draw further conclusions as more concrete guidelines may lead to uniformity in outcomes
Disclosures: Saqib Walayat indicated no relevant financial relationships. Muhammad Baig indicated no relevant financial relationships. Srinivas Puli indicated no relevant financial relationships. Daniel Martin indicated no relevant financial relationships.