IS THE ADENOMA DETECTION RATE AN IMPORTANT INDICATOR IN THE DETECTION OF OTHER NON-NEOPLASTIC FINDINGS?

Aims Adenoma detection rate (ADR) is the proportion of screening colonoscopy patients who are found to have at least one adenoma. ADR has been inversely associated with the risk of CRC and death. However little is known about the correlation of the adenoma detection rate and the detection of other non-neoplasic findings. The aim of this study was to evaluate if ADR is associated with a higher detection of non-neoplasic findings.

Methods We retrospectively analyzed patients undergoing colonoscopy by three endoscopists at our center (A, B, C). Angiodysplasia, diverticula, nonspecific inflammation, erosions or ulcers or subepithelial lesions were considered non-neoplastic findings.

Results A total of 229 colonoscopies were analyzed. The mean age was 64 ± 13.1 years-old. 54.6% were male (n = 125). The median ASA score was 2 (IQR: 1–3). The mean indication was post-polypectomy surveillance 25.8% (n = 59), followed by CRC surveillance 27.1% (n = 62) and screening for CRC 20.5% (n = 47). The indication for colonoscopy was significantly different between groups (p = 0.04): CRC surveillance was higher in endoscopist B (31.9%, n = 23) and C (36.5%, n = 23), and post-polypectomy surveillance was higher in endoscopist A (35.1%, n = 33). An excellent bowel cleansing was higher in colonoscopies performed by endoscopist A (A. 59.6% vs. B: 48.6% vs. C: 19%, p < 0.01). The global ADR was 36.2% (n = 83) and was not significantly different between endoscopists (A: 42.6% vs. B: 36.1% vs. C: 27%, p = 0.14). The ADR was not associated with higher detection rate of non-neoplasic findings (31.3% vs 30.1%, p = 0.88), even when concerning each endoscopist (A: 27.5% vs 33.3%, p = 0.65; B: 38.5% vs 23.9%, p = 0.28 e C: 29.4% vs 32.6%, p = 0.81).

Conclusions In our study, ADR was not associated with a better detection of other non-neoplastic findings in the total sample and by endoscopist.