Frequency of endoscopic photodocumentation of large colorectal polyps

Afshin A Khan; Muhammad Talal Sarmini; Ruth Bell; Jessica El Halabi; Ruishen Lyu; Carole Macaron; Amit Bhatt; Carol A Burke

doi:10.1016/j.gie.2023.06.010

Frequency of endoscopic photodocumentation of large colorectal polyps

Gastrointest Endosc. 2023 Nov;98(5):797-802. doi: 10.1016/j.gie.2023.06.010. Epub 2023 Jun 24.

Authors

Afshin A Khan¹, Muhammad Talal Sarmini², Ruth Bell¹, Jessica El Halabi¹, Ruishen Lyu³, Carole Macaron², Amit Bhatt², Carol A Burke⁴

Affiliations

¹ Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
² Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio, USA.
³ Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA.
⁴ Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio, USA. Electronic address: burkec1@ccf.org.

PMID: 37356633
DOI: 10.1016/j.gie.2023.06.010

Abstract

Background and aims: Colonoscopy quality affects colorectal cancer (CRC) incidence and mortality. The U.S. Multi-Society Task Force on Colorectal Cancer strongly recommends photodocumentation (PD) of lesions ≥10 mm in size (ie, large polyps [LPs]) pre-resection and suggests PD postresection to enhance the quality of colonoscopy. No studies have assessed the frequency of LP PD. We evaluated the frequency of and factors associated with PD of LPs.

Methods: Reports from endoscopists performing ≥50 colonoscopies with LP resection between 2016 and 2021 were reviewed. The frequency of LP PD pre-resection and post-resection and factors associated with PD were collected. A composite score of 2 quality metrics (PD of completeness of examination and bowel preparation quality) was created. Endoscopists were divided into 2 tiers based on the frequency of the score on all included examinations: Tier 1, ≥95% of examinations; and Tier 2, <95% of examinations. Univariate and multivariate analyses were used to assess factors associated with PD.

Results: A total of 1322 colonoscopies, 1693 LPs, and 25 endoscopists were included in this study. PD of LPs occurred in 1392 (82%) pre-resection and in 878 (52%) post-resection. Factors associated with pre-resection PD include endoscopist subspecialty (colorectal surgery vs gastroenterology: odds ratio [OR], .12; 95% confidence interval [CI], .04-.42); >1 LP on examination (2 vs 1 LP: OR, .41 [95% CI, .27-.61]; and ≥3 vs 1 LP: OR, .41 [95% CI, .24-.70]), and longer withdrawal time (OR, 1.02; 95% CI, 1.01-1.04).

Conclusions: We provide the first data on PD of LP pre-resection and post-resection, which can inform future benchmarking in this area. The implications of PD on metachronous advanced neoplasia need to be studied.