Adenoma Detection Rate and Risk of Colorectal Cancer and Death
Douglas A. Corley, Christopher D. Jensen, Amy R. Marks, Wei K. Zhao, Jeffrey K. Lee, Chyke A. Doubeni, Ann G. Zauber, Jolanda de Boer, Bruce H. Fireman, Joanne E. Schottinger, Virginia P. Quinn, Nirupa R. Ghai, Theodore R. Levin, and Charles P. Quesenberry, N Engl J Med 2014;370:1298-306.
Researchers from the Kaiser Permanente Health Group in California reviewed 314,872 colonoscopies that had been performed by 136 experienced gastroenterologists between 1998 and 2010 evaluating their individual Adenoma Detection Rate (ADR) and the number of interval cancers that occurred within ten years of the examination. ADR ranged from 7.4 to 52.5% and was inversely related to the risk of developing interval cancer. 712 interval cancers were identified causing 147 deaths. Each 1.0% increase in the adenoma detection rate was associated with a 3.0% decrease in the risk of cancer and a 5% risk of cancer death.
Conclusion:The adenoma detection rate was inversely associated with the risks of interval colorectal cancer, advanced-stage interval cancer, and fatal interval cancer.