Please use this identifier to cite or link to this item: https://hdl.handle.net/11000/30937

Factors associated with lesion detection in colonoscopy among different indications

Title:
Factors associated with lesion detection in colonoscopy among different indications
Authors:
Mangas-Sanjuan, Carolina  
Seoane, Agustín
Alvarez‐Gonzalez, Marco Antonio
Luè, Alberto
Suárez, Adolfo
Álvarez-García, Verónica
Bujanda, Luis  
Portillo, Isabel  
González, Natalia
Cid‐Gomez, Lucía
Cubiella, Joaquín
Rodríguez Camacho, Elena  
Ponce, Marta
Díez-Redondo, Pilar
Herraiz, Maite  
Pellisé, María
Ono, Akiko
Baile Maxía, Sandra  
Medina‐Prado, L.
Murcia, O
Zapater, Pedro
JOVER, RODRIGO  
Editor:
Wiley Online Library
Department:
Departamentos de la UMH::Medicina Clínica
Issue Date:
2022-11
URI:
https://hdl.handle.net/11000/30937
Abstract:
Background and objective: Different factors may influence colonoscopy performance measures. We aimed to analyze procedure- and endoscopist-related factors associated with detection of colorectal lesions and whether these factors have a similar influence in the context of different colonoscopy indications: positive fecal immunochemical test (+FIT) and post-polypectomy surveillance colonoscopies. Methods: This multicenter cross-sectional study included adults aged 40-80 years. Endoscopists (N = 96) who had performed ≥50 examinations were assessed for physician-related factors. Adenoma detection rate (ADR), adenomas per colonoscopy rate (APCR), advanced ADR, serrated polyp detection (SDR), and serrated polyps per colonoscopy rate (SPPCR) were calculated. Results: We included 12,932 procedures, with 4810 carried out after a positive FIT and 1967 for surveillance. Of the 96 endoscopists evaluated, 43.8% were women, and the mean age was 41.9 years. The ADR, advanced ADR, and SDR were 39.7%, 17.7%, and 12.8%, respectively. Adenoma detection rate was higher in colonoscopies after a +FIT (50.3%) with a more than doubled advanced ADR compared to non-FIT procedures (27.6% vs. 13.0%) and similar results in serrated lesions (14.7% vs. 13.5%). Among all the detection indicators analyzed, withdrawal time was the only factor independently related to improvement (p < 0.001). Regarding FIT-positive and surveillance procedures, for both indications, withdrawal time was also the only factor associated with a higher detection of adenomas and serrated polyps (p < 0.001). Endoscopist-related factors (i.e., weekly hours dedicated to endoscopy, annual colonoscopy volume and lifetime number of colonoscopies performed) had also impact on lesion detection (APCR, advanced ADR and SPPCR). Conclusions: Withdrawal time was the factor most commonly associated with improved detection of colonic lesions globally and in endoscopies for + FIT and post-polypectomy surveillance. Physician-related factors may help to address strategies to support training and service provision. Our results can be used for establishing future benchmarking and quality improvement in different colonoscopy indications.
Keywords/Subjects:
adenoma detection
colonoscopy
colorectal cancer
endoscopist
serrated polyp
Type of document:
application/pdf
Access rights:
info:eu-repo/semantics/openAccess
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
DOI:
https://doi.org/10.1002/ueg2.12325
Appears in Collections:
Artículos Medicina Clínica



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