Professor of Medicine University of Minnesota Minneapolis, MN
Aasma Shaukat, MD, MPH1, Jennifer Holub, MS2, Irving Pike, MD, FACG3, Mark Pochapin, MD4, David A. Greenwald, MD, FACG5, Colleen Schmitt, MD6, Glenn Eisen, MD7; 1University of Minnesota, Minneapolis, MN; 2GIQUIC, Bethesda, MD; 3Creek, Walnut Creek, CA; 4NYU, New York, NY; 5Mount Sinai Hospital, New York, NY; 6Chattanooga GI, Chattanooga, TN; 7Oregon Clinic, Oregon, OR
Introduction: Adenoma Detection rate (ADR) is an established quality indicator for screening colonoscopy. However, reported ADRs are highly variable across practices, and national or population-based estimates are not available. The aim of our study was to study the ADR, variability of rates over time and factors associated with detection rates of ADR in a national sample of patients undergoing colonoscopy using the GIQuIC registry. Methods: We used colonoscopies submitted to the GIQuIC registry from 2014 to 2018 on adults ages 50-89. Only the first colonoscopy record per patient was included. Indications for colonoscopy were categorized as screening, diagnostic and surveillance. We used hierarchical logistic models to study factors associated with ADR. Results: A total of 2,646,833 colonoscopies were performed by 1,169 endoscopists during the study period. The average ADR for screening colonoscopies per endoscopist was 36.80% (SD 10.21), 44.08 (SD 10.98) in males and 31.20 (SD 9.65) in females. Adjusted to the US population, the ADR was 39.08%. There was a significant increase in ADR from screening colonoscopies over the study period from 33.93% in 2014 to 38.12% in 2018. Clinically significant factors associated with higher ADR were age (OR 1.28; 95% CI 1.27-1.29 for 60-69; 1.57, 95% CI 1.55-1.58 for 70-79 compared to 50-59 years), male gender (OR 1.57; 95% CI 1.56-1.58), surveillance indication (vs. screening; OR 1.24; 95% CI 1.22, 1.26) and longer withdrawal times ( >11 minutes vs. ≤6 minutes) (OR 10.07; 95% CI 9.51-10.66). Discussion: Population based estimates of detection rates of ADR are 36.60% and have increased over time. Factors associated with ADR were patient age, gender and longer withdrawal time.
ADR by indication for colonoscopy over time for endoscopists with at least 30 exams per any year (n=1154 providers)
Trends of ADR by indication over time
Disclosures: Aasma Shaukat indicated no relevant financial relationships. Jennifer Holub indicated no relevant financial relationships. Irving Pike indicated no relevant financial relationships. Mark Pochapin indicated no relevant financial relationships. David Greenwald indicated no relevant financial relationships. Colleen Schmitt indicated no relevant financial relationships. Glenn Eisen indicated no relevant financial relationships.