Correlation between adenoma detection rate and polyp detection rate at endoscopy in a non-screening population

Sci Rep. 2020 Feb 10;10(1):2295. doi: 10.1038/s41598-020-58963-y.

Abstract

It is understood that colorectal adenomas progress to colonic adenocarcinoma. Adenoma detection rate (ADR) at endoscopy has been used as a key performance indicator at endoscopy and is inversely associated with diagnosis of interval colorectal cancer. As most endoscopy reporting systems do not routinely incorporate histological assessment, ADR reporting is a cumbersome task. Polyp Detection Rate (PDR) has therefore been adopted as a surrogate marker for ADR. A prospectively maintained database of colonoscopies performed between July 2015 and July 2017 was analysed. This was cross referenced with a histological database. Statistical analysis was performed using IBM SPSS, version 24. Inferential procedures employed included the Pearson's correlation coefficient (r) and Binomial logistic regression. Of 2964 procedures performed by 8 endoscopists, overall PDR was 27% and ADR was 19%. The PDR, ADR, adenoma to polyp detection rate quotient (APDRQ) and estimated ADR (PDR x APDRQ group average = 0.72) was calculated for each individual. There was a strong positive linear correlation between PDR and ADR,r(8) = 0.734, p = 0.038 and between PDR and estimated ADR, r(8) = 0.998, p < 0.001. Adenoma detection rate strongly correlated with estimated ADR, r(8) = 0.720, p = 0.044. With the exclusion of a moderate outlier, these correlations increased in both strength and significance. There was a stronger correlation between PDR and ADR,r(7) = 0.921, p = 0.003 and between ADR and estimated ADR, r(7) = 0.928, p = 0.003.

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / epidemiology*
  • Adenocarcinoma / pathology
  • Adenomatous Polyps / diagnosis
  • Adenomatous Polyps / epidemiology*
  • Adenomatous Polyps / pathology
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Colon / diagnostic imaging
  • Colon / pathology
  • Colonic Polyps / diagnosis
  • Colonic Polyps / epidemiology*
  • Colonic Polyps / pathology
  • Colonoscopy / statistics & numerical data*
  • Colorectal Neoplasms / diagnosis
  • Colorectal Neoplasms / epidemiology*
  • Colorectal Neoplasms / pathology
  • Disease Progression
  • Female
  • Humans
  • Intestinal Mucosa / diagnostic imaging
  • Intestinal Mucosa / pathology
  • Ireland / epidemiology
  • Male
  • Middle Aged
  • Prospective Studies
  • Rectum / diagnostic imaging
  • Rectum / pathology
  • Retrospective Studies
  • Young Adult