Skip to main content
Erschienen in: Current Treatment Options in Gastroenterology 2/2021

25.02.2021 | Endoscopy (P Siersema, Section Editor)

How to Measure Detection Rate During Colonoscopy: PDR, ADR, SDR, or All Three?

verfasst von: Einas Abou Ali, MD, Maximilien Barret, MD, PhD

Erschienen in: Current Treatment Options in Gastroenterology | Ausgabe 2/2021

Einloggen, um Zugang zu erhalten

Abstract

Purpose of review

Our aim was to clarify the respective role and significance of the adenoma detection rate (ADR) among other colonoscopy detection metrics such as the polyp detection rate (PDR) or the serrated polyp detection rate (SDR).

Recent findings

PDR is easy to measure, but affected by the resection of hyperplastic lesions in the distal colon, or non-neoplastic colorectal mucosa, and cannot be considered a reliable detection metric. The use of SDR is limited by the heterogeneity of the serrated lesions. In 2021, the ADR remains sole recommended detection metric, inversely correlated to interval colorectal cancer and death, and correlated to most other colonoscopy detection metrics.
Literatur
1.
Zurück zum Zitat Dekker E, Tanis PJ, Vleugels JLA, Kasi PM, Wallace MB. Colorectal Cancer Lancet. 2019;394(10207):1467–80.PubMed Dekker E, Tanis PJ, Vleugels JLA, Kasi PM, Wallace MB. Colorectal Cancer Lancet. 2019;394(10207):1467–80.PubMed
2.
Zurück zum Zitat Dekker E, Rex DK. Advances in CRC Prevention: Screening and Surveillance. Gastroenterology. 2018;154(7):1970–84.CrossRef Dekker E, Rex DK. Advances in CRC Prevention: Screening and Surveillance. Gastroenterology. 2018;154(7):1970–84.CrossRef
3.
Zurück zum Zitat Zauber AG, Winawer SJ, O’Brien MJ, Lansdorp-Vogelaar I, van Ballegooijen M, Hankey BF, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012;366(8):687–96.CrossRef Zauber AG, Winawer SJ, O’Brien MJ, Lansdorp-Vogelaar I, van Ballegooijen M, Hankey BF, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012;366(8):687–96.CrossRef
4.
Zurück zum Zitat Aniwan S, Orkoonsawat P, Viriyautsahakul V, Angsuwatcharakon P, Pittayanon R, Wisedopas N, et al. The Secondary Quality Indicator to Improve Prediction of Adenoma Miss Rate Apart from Adenoma Detection Rate. Am J Gastroenterol. 2016;111(5):723–9.CrossRef Aniwan S, Orkoonsawat P, Viriyautsahakul V, Angsuwatcharakon P, Pittayanon R, Wisedopas N, et al. The Secondary Quality Indicator to Improve Prediction of Adenoma Miss Rate Apart from Adenoma Detection Rate. Am J Gastroenterol. 2016;111(5):723–9.CrossRef
5.
Zurück zum Zitat Kaminski MF, Thomas-Gibson S, Bugajski M, Bretthauer M, Rees CJ, Dekker E, et al. Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy. 2017;49(4):378–97.CrossRef Kaminski MF, Thomas-Gibson S, Bugajski M, Bretthauer M, Rees CJ, Dekker E, et al. Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy. 2017;49(4):378–97.CrossRef
6.
Zurück zum Zitat May FP, Shaukat A. State of the Science on Quality Indicators for Colonoscopy and How to Achieve Them. Am J Gastroenterol. 2020;115(8):1183–90.CrossRef May FP, Shaukat A. State of the Science on Quality Indicators for Colonoscopy and How to Achieve Them. Am J Gastroenterol. 2020;115(8):1183–90.CrossRef
7.
Zurück zum Zitat Corley DA, Jensen CD, Marks AR, Zhao WK, Lee JK, Doubeni CA, et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med. 2014;370(14):1298–306.CrossRef Corley DA, Jensen CD, Marks AR, Zhao WK, Lee JK, Doubeni CA, et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med. 2014;370(14):1298–306.CrossRef
8.
Zurück zum Zitat Kaminski MF, Anderson J, Valori R, Kraszewska E, Rupinski M, Pachlewski J, et al. Leadership training to improve adenoma detection rate in screening colonoscopy: a randomised trial. Gut. 2016;65(4):616–24.CrossRef Kaminski MF, Anderson J, Valori R, Kraszewska E, Rupinski M, Pachlewski J, et al. Leadership training to improve adenoma detection rate in screening colonoscopy: a randomised trial. Gut. 2016;65(4):616–24.CrossRef
9.
Zurück zum Zitat Lam AY, Li Y, Gregory DL, Prinz J, O’Reilly J, Manka M, et al. Association between improved adenoma detection rates and interval colorectal cancer rates after a quality improvement program. Gastrointest Endosc. 2020;92(2):355–364.e5.CrossRef Lam AY, Li Y, Gregory DL, Prinz J, O’Reilly J, Manka M, et al. Association between improved adenoma detection rates and interval colorectal cancer rates after a quality improvement program. Gastrointest Endosc. 2020;92(2):355–364.e5.CrossRef
10.
Zurück zum Zitat Kaminski MF, Regula J, Kraszewska E, Polkowski M, Wojciechowska U, Didkowska J, et al. Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med. 2010;362(19):1795–803.CrossRef Kaminski MF, Regula J, Kraszewska E, Polkowski M, Wojciechowska U, Didkowska J, et al. Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med. 2010;362(19):1795–803.CrossRef
11.
Zurück zum Zitat Mangas-Sanjuan C, Zapater P, Cubiella J, Murcia Ó, Bujanda L, Hernández V, et al. Importance of endoscopist quality metrics for findings at surveillance colonoscopy: The detection-surveillance paradox. United European Gastroenterol J. 2018;6(4):622–9.CrossRef Mangas-Sanjuan C, Zapater P, Cubiella J, Murcia Ó, Bujanda L, Hernández V, et al. Importance of endoscopist quality metrics for findings at surveillance colonoscopy: The detection-surveillance paradox. United European Gastroenterol J. 2018;6(4):622–9.CrossRef
12.
Zurück zum Zitat Kahi CJ, Vemulapalli KC, Johnson CS, Rex DK. Improving measurement of the adenoma detection rate and adenoma per colonoscopy quality metric: the Indiana University experience. Gastrointest Endosc. 2014;79(3):448–54.CrossRef Kahi CJ, Vemulapalli KC, Johnson CS, Rex DK. Improving measurement of the adenoma detection rate and adenoma per colonoscopy quality metric: the Indiana University experience. Gastrointest Endosc. 2014;79(3):448–54.CrossRef
13.
Zurück zum Zitat Kaminski MF, Wieszczy P, Rupinski M, Wojciechowska U, Didkowska J, Kraszewska E, et al. Increased Rate of Adenoma Detection Associates With Reduced Risk of Colorectal Cancer and Death. Gastroenterology. 2017;153(1):98–105.CrossRef Kaminski MF, Wieszczy P, Rupinski M, Wojciechowska U, Didkowska J, Kraszewska E, et al. Increased Rate of Adenoma Detection Associates With Reduced Risk of Colorectal Cancer and Death. Gastroenterology. 2017;153(1):98–105.CrossRef
14.
Zurück zum Zitat Rex DK, Schoenfeld PS, Cohen J, Pike IM, Adler DG, Fennerty MB, et al. Quality indicators for colonoscopy. Gastrointest Endosc. 2015;81(1):31–53.CrossRef Rex DK, Schoenfeld PS, Cohen J, Pike IM, Adler DG, Fennerty MB, et al. Quality indicators for colonoscopy. Gastrointest Endosc. 2015;81(1):31–53.CrossRef
15.
Zurück zum Zitat Mangas-Sanjuan C, Santana E, Cubiella J, Rodríguez-Camacho E, Seoane A, Alvarez-Gonzalez MA, et al. Variation in Colonoscopy Performance Measures According to Procedure Indication. Clin Gastroenterol Hepatol. 2020;18(5):1216–1223.e2.CrossRef Mangas-Sanjuan C, Santana E, Cubiella J, Rodríguez-Camacho E, Seoane A, Alvarez-Gonzalez MA, et al. Variation in Colonoscopy Performance Measures According to Procedure Indication. Clin Gastroenterol Hepatol. 2020;18(5):1216–1223.e2.CrossRef
16.
Zurück zum Zitat Fedewa SA, Anderson JC, Robinson CM, Weiss JE, Smith RA, Siegel RL, et al. Prevalence of “one and done” in adenoma detection rates: results from the New Hampshire Colonoscopy Registry. Endosc Int Open. 2019;7(11):E1344–54.CrossRef Fedewa SA, Anderson JC, Robinson CM, Weiss JE, Smith RA, Siegel RL, et al. Prevalence of “one and done” in adenoma detection rates: results from the New Hampshire Colonoscopy Registry. Endosc Int Open. 2019;7(11):E1344–54.CrossRef
17.
Zurück zum Zitat Aniwan S, Vanduangden K, Kerr SJ, Wisedopas N, Kongtab N, Kullavanijaya P, et al. Usefulness of mean number of adenomas per positive screenee for identifying meticulous endoscopists among those who achieve acceptable adenoma detection rates. Endoscopy. 2020. Aniwan S, Vanduangden K, Kerr SJ, Wisedopas N, Kongtab N, Kullavanijaya P, et al. Usefulness of mean number of adenomas per positive screenee for identifying meticulous endoscopists among those who achieve acceptable adenoma detection rates. Endoscopy. 2020.
18.
Zurück zum Zitat Click B, Pinsky PF, Hickey T, Doroudi M, Schoen RE. Association of Colonoscopy Adenoma Findings With Long-term Colorectal Cancer Incidence. JAMA. 2018;319(19):2021–31.CrossRef Click B, Pinsky PF, Hickey T, Doroudi M, Schoen RE. Association of Colonoscopy Adenoma Findings With Long-term Colorectal Cancer Incidence. JAMA. 2018;319(19):2021–31.CrossRef
19.
Zurück zum Zitat Greenspan M, Rajan KB, Baig A, Beck T, Mobarhan S, Melson J. Advanced adenoma detection rate is independent of nonadvanced adenoma detection rate. Am J Gastroenterol. 2013;108(8):1286–92.CrossRef Greenspan M, Rajan KB, Baig A, Beck T, Mobarhan S, Melson J. Advanced adenoma detection rate is independent of nonadvanced adenoma detection rate. Am J Gastroenterol. 2013;108(8):1286–92.CrossRef
20.
Zurück zum Zitat Klair JS, Ashat M, Johnson D, Arora S, Onteddu N, Machain Palacio JG, et al. Serrated polyp detection rate and advanced adenoma detection rate from a US multicenter cohort. Endoscopy. 2020;52(1):61–7.CrossRef Klair JS, Ashat M, Johnson D, Arora S, Onteddu N, Machain Palacio JG, et al. Serrated polyp detection rate and advanced adenoma detection rate from a US multicenter cohort. Endoscopy. 2020;52(1):61–7.CrossRef
21.
Zurück zum Zitat East JE, Atkin WS, Bateman AC, Clark SK, Dolwani S, Ket SN, et al. British Society of Gastroenterology position statement on serrated polyps in the colon and rectum. Gut. 2017;66(7):1181–96.CrossRef East JE, Atkin WS, Bateman AC, Clark SK, Dolwani S, Ket SN, et al. British Society of Gastroenterology position statement on serrated polyps in the colon and rectum. Gut. 2017;66(7):1181–96.CrossRef
22.
Zurück zum Zitat Anderson JC, Butterly LF, Weiss JE, Robinson CM. Providing data for serrated polyp detection rate benchmarks: an analysis of the New Hampshire Colonoscopy Registry. Gastrointest Endosc. 2017;85(6):1188–94.CrossRef Anderson JC, Butterly LF, Weiss JE, Robinson CM. Providing data for serrated polyp detection rate benchmarks: an analysis of the New Hampshire Colonoscopy Registry. Gastrointest Endosc. 2017;85(6):1188–94.CrossRef
23.
Zurück zum Zitat Zorzi M, Senore C, Da Re F, Barca A, Bonelli LA, Cannizzaro R, et al. Detection rate and predictive factors of sessile serrated polyps in an organised colorectal cancer screening programme with immunochemical faecal occult blood test: the EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy). Gut. 2017;66(7):1233–40.CrossRef Zorzi M, Senore C, Da Re F, Barca A, Bonelli LA, Cannizzaro R, et al. Detection rate and predictive factors of sessile serrated polyps in an organised colorectal cancer screening programme with immunochemical faecal occult blood test: the EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy). Gut. 2017;66(7):1233–40.CrossRef
24.
Zurück zum Zitat Maratt JK, Dickens J, Schoenfeld PS, Elta GH, Jackson K, Rizk D, et al. Factors Associated with Surveillance Adenoma and Sessile Serrated Polyp Detection Rates. Dig Dis Sci. 2017;62(12):3579–85.CrossRef Maratt JK, Dickens J, Schoenfeld PS, Elta GH, Jackson K, Rizk D, et al. Factors Associated with Surveillance Adenoma and Sessile Serrated Polyp Detection Rates. Dig Dis Sci. 2017;62(12):3579–85.CrossRef
25.
Zurück zum Zitat IJspeert JEG, de Wit K, van der Vlugt M, Bastiaansen BAJ, Fockens P, Dekker E. Prevalence, distribution and risk of sessile serrated adenomas/polyps at a center with a high adenoma detection rate and experienced pathologists. Endoscopy. 2016;48(8):740–6.CrossRef IJspeert JEG, de Wit K, van der Vlugt M, Bastiaansen BAJ, Fockens P, Dekker E. Prevalence, distribution and risk of sessile serrated adenomas/polyps at a center with a high adenoma detection rate and experienced pathologists. Endoscopy. 2016;48(8):740–6.CrossRef
26.
Zurück zum Zitat Pai RK, Mäkinen MJ, Rosty C. Colorectal serrated lesions and polyps. In: Nagtegaal ID, Arends MJ, Odze RD, Lam AK, editors. WHO Classification of Tumours of the Digestive System. Lyon: IARC Press; 2019. p. 163–9. Pai RK, Mäkinen MJ, Rosty C. Colorectal serrated lesions and polyps. In: Nagtegaal ID, Arends MJ, Odze RD, Lam AK, editors. WHO Classification of Tumours of the Digestive System. Lyon: IARC Press; 2019. p. 163–9.
27.
Zurück zum Zitat Ng S, Sreenivasan AK, Pecoriello J, Liang PS. Polyp Detection Rate Correlates Strongly with Adenoma Detection Rate in Trainee Endoscopists. Dig Dis Sci. 2020;65(8):2229–33.CrossRef Ng S, Sreenivasan AK, Pecoriello J, Liang PS. Polyp Detection Rate Correlates Strongly with Adenoma Detection Rate in Trainee Endoscopists. Dig Dis Sci. 2020;65(8):2229–33.CrossRef
28.
Zurück zum Zitat Boroff ES, Gurudu SR, Hentz JG, Leighton JA, Ramirez FC. Polyp and adenoma detection rates in the proximal and distal colon. Am J Gastroenterol. 2013;108(6):993–9.CrossRef Boroff ES, Gurudu SR, Hentz JG, Leighton JA, Ramirez FC. Polyp and adenoma detection rates in the proximal and distal colon. Am J Gastroenterol. 2013;108(6):993–9.CrossRef
29.
Zurück zum Zitat Melson J, Berger D, Greenspan M, Bayoumi M, Jakate S. Maintaining low non-neoplastic polypectomy rates in high-quality screening colonoscopy. Gastrointest Endosc. 2017;85(3):581–7.CrossRef Melson J, Berger D, Greenspan M, Bayoumi M, Jakate S. Maintaining low non-neoplastic polypectomy rates in high-quality screening colonoscopy. Gastrointest Endosc. 2017;85(3):581–7.CrossRef
30.
Zurück zum Zitat van Doorn SC, van Vliet J, Fockens P, Dekker E. A novel colonoscopy reporting system enabling quality assurance. Endoscopy. 2014;46(3):181–7.CrossRef van Doorn SC, van Vliet J, Fockens P, Dekker E. A novel colonoscopy reporting system enabling quality assurance. Endoscopy. 2014;46(3):181–7.CrossRef
31.
Zurück zum Zitat Bronzwaer MES, Vleugels JLA, van Doorn SC, Dijkgraaf MGW, Fockens P, Dekker E, et al. Are adenoma and serrated polyp detection rates correlated with endoscopists’ sensitivity of optical diagnosis? Endoscopy. 2020;52(9):763–72.CrossRef Bronzwaer MES, Vleugels JLA, van Doorn SC, Dijkgraaf MGW, Fockens P, Dekker E, et al. Are adenoma and serrated polyp detection rates correlated with endoscopists’ sensitivity of optical diagnosis? Endoscopy. 2020;52(9):763–72.CrossRef
32.
Zurück zum Zitat Laique SN, Hayat U, Sarvepalli S, Vaughn B, Ibrahim M, McMichael J, et al. Application of optical character recognition with natural language processing for large-scale quality metric data extraction in colonoscopy reports. Gastrointest Endosc. 2020. Laique SN, Hayat U, Sarvepalli S, Vaughn B, Ibrahim M, McMichael J, et al. Application of optical character recognition with natural language processing for large-scale quality metric data extraction in colonoscopy reports. Gastrointest Endosc. 2020.
33.
Zurück zum Zitat Shao PP, Bui A, Romero T, Jia H, Leung FW. Adenoma and Advanced Adenoma Detection Rates of Water Exchange, Endocuff, and Cap Colonoscopy: A Network Meta-Analysis with Pooled Data of Randomized Controlled Trials. Dig Dis Sci. 2020. Shao PP, Bui A, Romero T, Jia H, Leung FW. Adenoma and Advanced Adenoma Detection Rates of Water Exchange, Endocuff, and Cap Colonoscopy: A Network Meta-Analysis with Pooled Data of Randomized Controlled Trials. Dig Dis Sci. 2020.
34.
Zurück zum Zitat Rex DK, Repici A, Gross SA, Hassan C, Ponugoti PL, Garcia JR, et al. High-definition colonoscopy versus Endocuff versus EndoRings versus full-spectrum endoscopy for adenoma detection at colonoscopy: a multicenter randomized trial. Gastrointest Endosc. 2018;88(2):335–344.e2.CrossRef Rex DK, Repici A, Gross SA, Hassan C, Ponugoti PL, Garcia JR, et al. High-definition colonoscopy versus Endocuff versus EndoRings versus full-spectrum endoscopy for adenoma detection at colonoscopy: a multicenter randomized trial. Gastrointest Endosc. 2018;88(2):335–344.e2.CrossRef
35.
Zurück zum Zitat Karsenti D, Tharsis G, Perrot B, Cattan P, Tordjman G, Venezia F, et al. Adenoma detection by Endocuff-assisted versus standard colonoscopy in routine practice: a cluster-randomised crossover trial. Gut. 2020;69(12):2159–64.CrossRef Karsenti D, Tharsis G, Perrot B, Cattan P, Tordjman G, Venezia F, et al. Adenoma detection by Endocuff-assisted versus standard colonoscopy in routine practice: a cluster-randomised crossover trial. Gut. 2020;69(12):2159–64.CrossRef
36.
Zurück zum Zitat Wang P, Liu X, Berzin TM, Glissen Brown JR, Liu P, Zhou C, et al. Effect of a deep-learning computer-aided detection system on adenoma detection during colonoscopy (CADe-DB trial): a double-blind randomised study. Lancet Gastroenterol Hepatol. 2020;5(4):343–51. Wang P, Liu X, Berzin TM, Glissen Brown JR, Liu P, Zhou C, et al. Effect of a deep-learning computer-aided detection system on adenoma detection during colonoscopy (CADe-DB trial): a double-blind randomised study. Lancet Gastroenterol Hepatol. 2020;5(4):343–51.
37.
Zurück zum Zitat • Hassan C, Spadaccini M, Iannone A, Maselli R, Jovani M, Chandrasekar VT, et al. Performance of artificial intelligence in colonoscopy for adenoma and polyp detection: a systematic review and meta-analysis. Gastrointest Endosc. 2021;93(1):77–85.e6 This meta-analysis showed that artificial intelligence outperformed the endoscopists alone for the detection of colorectal adenomas and serrated lesions. • Hassan C, Spadaccini M, Iannone A, Maselli R, Jovani M, Chandrasekar VT, et al. Performance of artificial intelligence in colonoscopy for adenoma and polyp detection: a systematic review and meta-analysis. Gastrointest Endosc. 2021;93(1):77–85.e6 This meta-analysis showed that artificial intelligence outperformed the endoscopists alone for the detection of colorectal adenomas and serrated lesions.
Metadaten
Titel
How to Measure Detection Rate During Colonoscopy: PDR, ADR, SDR, or All Three?
verfasst von
Einas Abou Ali, MD
Maximilien Barret, MD, PhD
Publikationsdatum
25.02.2021
Verlag
Springer US
Erschienen in
Current Treatment Options in Gastroenterology / Ausgabe 2/2021
Print ISSN: 1092-8472
Elektronische ISSN: 1534-309X
DOI
https://doi.org/10.1007/s11938-021-00338-x

Weitere Artikel der Ausgabe 2/2021

Current Treatment Options in Gastroenterology 2/2021 Zur Ausgabe

Liver (J Bajaj, Section Editor)

Metabolomics in Advanced Liver Disease

Nutrition and Obesity (O Pickett-Blakeley, Section Editor)

Treatment of Micronutrient Deficiencies Pre and Post Bariatric Surgery

Genetics in Gastroenterology Practice (BW Katona, Section Editor)

Management of Familial Adenomatous Polyposis

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.