Quality Indicators for Colonoscopy and the Risk of Interval Cancer
Michal F. Kaminski, Jaroslaw Regula, Ewa Kraszewska, Marcin Polkowski, Urszula Wojciechowska, Joanna Didkowska, Maria Zwierko, Maciej Rupinski, Marek P. Nowacki, and Eugeniusz Butruk, N Engl J Med 2010;362:1795-803
This study evaluated 186 endoscopists and 45,026 subjects who underwent colonoscopy for colorectal screening. 42 interval colorectal cancers were identified. A low ADR was associated with a greater risk of interval colorectal cancer (P = 0.008.) adenoma detection rates of less than 11.0%, 11.0 to 14.9%, and 15.0 to 19.9%, as compared with a rate of 20.0% or higher, had hazard ratios of 10.94, 10.75 and 12.50 respectively (P = 0.02 for all comparisons).
Conclusion: The adenoma detection rate is an independent predictor of the risk of interval colorectal cancer after screening colonoscopy.