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Showing content from https://pubmed.ncbi.nlm.nih.gov/28428142/ below:

Increased Rate of Adenoma Detection Associates With Reduced Risk of Colorectal Cancer and Death

Affiliations

• ¹ Department of Gastroenterological Oncology, Maria-Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland; Department of Gastroenterology, Hepatology and Oncology, Medical Center for Postgraduate Education, Warsaw, Poland; Institute of Health and Society, University of Oslo, Oslo, Norway; Department of Cancer Prevention, Maria-Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland. Electronic address: mfkaminski@coi.waw.pl.
• ² Department of Gastroenterological Oncology, Maria-Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland; Department of Gastroenterology, Hepatology and Oncology, Medical Center for Postgraduate Education, Warsaw, Poland; Department of Cancer Prevention, Maria-Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.
• ³ Department of Gastroenterological Oncology, Maria-Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland; Department of Gastroenterology, Hepatology and Oncology, Medical Center for Postgraduate Education, Warsaw, Poland.
• ⁴ National Cancer Registry of Poland, Maria-Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.
• ⁵ Department of Cancer Prevention, Maria-Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.
• ⁶ Department of Gastroenterology, Hepatology and Oncology, Medical Center for Postgraduate Education, Warsaw, Poland.
• ⁷ Department of Gastroenterology, Hepatology and Oncology, Medical Center for Postgraduate Education, Warsaw, Poland; Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk-Invasive Medicine Centre, Gdansk, Poland.
• ⁸ Department of Gastroenterological Oncology, Maria-Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.

• PMID: 28428142
• DOI: 10.1053/j.gastro.2017.04.006

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Michal F Kaminski et al. Gastroenterology. 2017 Jul.

• ¹ Department of Gastroenterological Oncology, Maria-Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland; Department of Gastroenterology, Hepatology and Oncology, Medical Center for Postgraduate Education, Warsaw, Poland; Institute of Health and Society, University of Oslo, Oslo, Norway; Department of Cancer Prevention, Maria-Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland. Electronic address: mfkaminski@coi.waw.pl.
• ² Department of Gastroenterological Oncology, Maria-Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland; Department of Gastroenterology, Hepatology and Oncology, Medical Center for Postgraduate Education, Warsaw, Poland; Department of Cancer Prevention, Maria-Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.
• ³ Department of Gastroenterological Oncology, Maria-Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland; Department of Gastroenterology, Hepatology and Oncology, Medical Center for Postgraduate Education, Warsaw, Poland.
• ⁴ National Cancer Registry of Poland, Maria-Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.
• ⁵ Department of Cancer Prevention, Maria-Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.
• ⁶ Department of Gastroenterology, Hepatology and Oncology, Medical Center for Postgraduate Education, Warsaw, Poland.
• ⁷ Department of Gastroenterology, Hepatology and Oncology, Medical Center for Postgraduate Education, Warsaw, Poland; Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk-Invasive Medicine Centre, Gdansk, Poland.
• ⁸ Department of Gastroenterological Oncology, Maria-Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland.

• PMID: 28428142
• DOI: 10.1053/j.gastro.2017.04.006

Item in Clipboard

Background & aims: The quality of endoscopists' colonoscopy performance is measured by adenoma detection rate (ADR). Although ADR is associated inversely with interval colorectal cancer and colorectal cancer death, the effects of an increasing ADR have not been shown. We investigated whether increasing ADRs from individual endoscopists is associated with reduced risks of interval colorectal cancer and subsequent death.

Methods: We performed a prospective cohort study of individuals who underwent a screening colonoscopy within the National Colorectal Cancer Screening Program in Poland, from January 1, 2004, through December 31, 2008. We collected data from 146,860 colonoscopies performed by 294 endoscopists, with each endoscopist having participated at least twice in annual editions of primary colonoscopy screening. We used annual feedback and quality benchmark indicators to improve colonoscopy performance. We used ADR quintiles in the whole data set to categorize the annual ADRs for each endoscopist. An increased ADR was defined as an increase by at least 1 quintile category, or the maintenance of the highest category in subsequent screening years. Multivariate frailty models were used to evaluate the effects of increased ADR on the risk of interval colorectal cancer and death.

Results: Throughout the enrollment period, 219 endoscopists (74.5%) increased their annual ADR category. During 895,916 person-years of follow-up evaluation through the National Cancer Registry, we identified 168 interval colorectal cancers and 44 interval cancer deaths. An increased ADR was associated with an adjusted hazard ratio for interval colorectal cancer of 0.63 (95% confidence interval [CI], 0.45-0.88; P = .006), and for cancer death of 0.50 (95% CI, 0.27-0.95; P = .035). Compared with no increase in ADR, reaching or maintaining the highest quintile ADR category (such as an ADR > 24.56%) decreased the adjusted hazard ratios for interval colorectal cancer to 0.27 (95% CI, 0.12-0.63; P = .003), and 0.18 (95% CI, 0.06-0.56; P = .003), respectively.

Conclusions: In a prospective study of individuals who underwent screening colonoscopy within a National Colorectal Cancer Screening Program, we associated increased ADR with a reduced risk of interval colorectal cancer and death.

Keywords: Colon Cancer; Early Detection; Efficacy; Tumor.

Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

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