275 – Determination of Benchmarks for Serrated Polyp Detection Rate and Advanced Adenoma Detection Rate from a US Multicenter Cohort

Abstract

ABSTRACT Background & Aims: Interval colorectal cancers are inversely proportional to adenoma detection rate (ADR), serrated polyp detection rate (SDR) and advanced adenoma detection rate (AADR). Prior studies have shown that an adequate ADR does not necessarily imply good SDR and AADR. Clinically significant SDR benchmark of 7% was recently proposed from a single region cohort in the United States. We aimed to validate their SDR benchmark in a multi-center cohort from Mid-west and Southern United States cohort and establish an AADR benchmark. Methods: We included average risk screening colonoscopies from four different medical centers in the Midwest and Southern US from Oct. 2016 to Oct. 2018. Providers with at least 100 average risk-screening colonoscopies were included. We calculated non-parametric Spearman correlation coefficients for ADR and SDR, and ADR and AADR. Median SDR and AADR were calculated from providers with adequate ADR. SDR and AADR benchmark was established from median SDR and median AADR for providers with adequate ADR> 25% but less than 45%. Results: We included 3065 screening colonoscopies performed by 22 gastroenterologists. Mean age was 57.7±7.4, 1385 (45%) were males. All providers had ADR above 25% (range 29-65) Table 1. There was a significant, positive, but a modest correlation for ADR and SDR (rho=0.59, p=0.03), and ADR and AADR (rho=0.65, p<0.01). Median (IQR) ADR of all providers was 43 (33-49.3), median SDR 8.8 (7.8-12.5), and AADR 8.9 (6.5-12.8). For providers with ADR between 25 to 45%, median ADR was 38 (32-43), median SDR 8.1 (7-8.7), and median AADR 6.8 (5.4, 10.3) Table 2. Adenomas (p<0.01) and advanced adenomas (p=0.027) were more commonly seen in males, while female sex was a significant predictor of serrated polyps (p=0.007). Conclusion: Based on a multicenter United States Mid-western and Southern cohort, we propose benchmarks for SDR (8%) and AADR (7%). Inclusion of these benchmarks in guidelines has potential to improve colonoscopy quality for providers with low ADR, SDR and/or AADR, thereby decreasing the risk of interval colorectal cancers. [Table Presented] [Table Presented]