Endoscopy
DOI: 10.1055/a-0597-1740
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopist factors that influence serrated polyp detection: a multicenter study

Seth D. Crockett
1  Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States
,
Rebecca A. Gourevitch
2  Harvard Medical School, Boston, Massachusetts, United States
,
Michele Morris
3  Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
,
David S. Carrell
4  Kaiser Permanente of Washington Health Research Institute, Seattle, Washington, United States
,
Sherri Rose
2  Harvard Medical School, Boston, Massachusetts, United States
,
Zhuo Shi
2  Harvard Medical School, Boston, Massachusetts, United States
,
Julia B. Greer
5  Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
,
Robert E. Schoen
5  Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
,
Ateev Mehrotra
2  Harvard Medical School, Boston, Massachusetts, United States
› Author Affiliations
Further Information

Publication History

submitted 18 September 2017

accepted after revision: 28 February 2018

Publication Date:
24 April 2018 (eFirst)

Abstract

Background Serrated polyps are important colorectal cancer precursors that are variably detected during colonoscopy. We measured serrated polyp detection rate (SPDR) in a large, multicenter, cross-sectional study of colonoscopy quality to identify drivers of SPDR variation.

Methods Colonoscopy and pathology reports were collected for a 2-year period (10/2013-9/2015) from four sites across the United States. Data from reports, including size, location, and histology of polyps, were abstracted using a validated natural language processing algorithm. SPDR was defined as the proportion of colonoscopies with ≥ 1 serrated polyp (not including hyperplastic polyps). Multivariable logistic regression was performed to determine endoscopist characteristics associated with serrated polyp detection.

Results A total of 104 618 colonoscopies were performed by 201 endoscopists who varied with respect to specialty (86 % were gastroenterologists), sex (18 % female), years in practice (range 1 – 51), and number of colonoscopies performed during the study period (range 30 – 2654). The overall mean SPDR was 5.1 % (SD 3.8 %, range 0 – 18.8 %). In multivariable analysis, gastroenterology specialty training (odds ratio [OR] 1.89, 95 % confidence interval [CI] 1.33 – 2.70), fewer years in practice (≤ 9 years vs. ≥ 27 years: OR 1.52, 95 %CI 1.14 – 2.04)], and higher procedure volumes (highest vs. lowest quartile: OR 1.77, 95 %CI 1.27 – 2.46)] were independently associated with serrated polyp detection.

Conclusions Gastroenterology specialization, more recent completion of training, and greater procedure volume are associated with serrated polyp detection. These findings imply that both repetition and training are likely to be important contributors to adequate detection of these important cancer precursors. Additional efforts to improve SPDR are needed.

Tables e3, e5, e6