Serrated polyp detection rate and advanced adenoma detection rate from a US multicenter cohort

Abstract

Background Interval colorectal cancers may be associated with a low serrated polyp detection rate (SDR) and advanced adenoma detection rate (AADR). We aimed to determine the SDR and AADR for endoscopists in a United States multicenter cohort. Methods We included average-risk screening colonoscopies from five medical centers in the United States. Endoscopists with data on at least 100 average-risk screening colonoscopies were included. We calculated median SDR and AADR for endoscopists with adequate adenoma detection rates (ADRs) >25%. We analyzed the relationship between ADR and SDR, and between ADR and AADR using nonparametric Spearman correlation coefficients, scatter plots, and linear regression. Results We included 3513 screening colonoscopies performed by 26 gastroenterologists. The mean age of patients was 56.8 years (SD 7.4) and 1585 (45%) were male. All but one endoscopist had an ADR above 25%. There was a significant positive but modest correlation between ADR and SDR (rho=0.67, P <0.01), and between ADR and AADR (rho=0.56, P <0.01). For endoscopists with an adequate ADR, median (interquartile range) ADR was 43% (32.0%-48.6%), median SDR was 8.4% (7.3%-11.4%), and median AADR was 9.3% (6.4%-12.6%). Conclusion A significant percentage of endoscopists have either a low SDR or low AADR despite an adequate ADR, justifying the need for separate SDR and AADR benchmarks. Based on our multicenter cohort, endoscopists with adequate ADRs had a median SDR and median AADR of about 8% and 9%, respectively.