Factors associated with lesion detection in colonoscopy among different indications.

Autor: Mangas-Sanjuan C; Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL, Alicante, Spain., Seoane A; Department of Gastroenterology, Parc de Salut Mar, Hospital del Mar, Barcelona, Spain., Alvarez-Gonzalez MA; Department of Gastroenterology, Parc de Salut Mar, Hospital del Mar, Barcelona, Spain., Luè A; Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Aragon Health Research Institute, IIS Aragon, Zaragoza, Spain., Suárez A; Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain., Álvarez-García V; Department of Gastroenterology, Hospital Universitario Central de Asturias, Oviedo, Spain., Bujanda L; Department of Gastroenterology, Biodonostia Medical Research Institute, San Sebastián, Spain., Portillo I; Basque Country Colorectal Cancer Screening Programme, Osakidetza, Basque Health Service, Bilbao, Spain., González N; Department of Gastroenterology, Hospital Universitario de Canarias, Instituto Universitario de Tecnologías Biomédicas & Centro de Investigación Biomédica de Canarias (CIBICAN), Santa Cruz de Tenerife, Spain., Cid-Gomez L; Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Instituto de Investigación Biomédica, Xerencia de Xestión Integrada de Vigo, Vigo, Spain., Cubiella J; Department of Gastroenterology, Complexo Hospitalario de Ourense, Instituto de Investigación Biomédica de Ourense, Pontevedra y Vigo, Ourense, Spain., Rodríguez-Camacho E; Dirección Xeral de Saúde Pública, Consellería de Sanidade, Santiago de Compostela, Spain., Ponce M; Department of Gastroenterology, Hospital Universitario La Fe, Valencia, Spain., Díez-Redondo P; Endoscopy Unit, Hospital Universitario Rio Hortega, Valladolid, Spain., Herráiz M; Department of Gastroenterology, Clínica Universitaria and Medical School, University of Navarra, Navarra, Spain., Pellisé M; Department of Gastroenterology, Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain., Ono A; Unidad de Gestión Clínica de Digestivo, Hospital Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria, Murcia, Spain., Baile-Maxía S; Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL, Alicante, Spain., Medina-Prado L; Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL, Alicante, Spain., O M; Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL, Alicante, Spain., Zapater P; Unit of Clinical Pharmacology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL, Alicante, Spain., Jover R; Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL, Alicante, Spain.
Jazyk: angličtina
Zdroj: United European gastroenterology journal [United European Gastroenterol J] 2022 Nov; Vol. 10 (9), pp. 1008-1019. Date of Electronic Publication: 2022 Oct 27.
DOI: 10.1002/ueg2.12325
Abstrakt: Background and Objective: Different factors may influence colonoscopy performance measures. We aimed to analyze procedure- and endoscopist-related factors associated with detection of colorectal lesions and whether these factors have a similar influence in the context of different colonoscopy indications: positive fecal immunochemical test (+FIT) and post-polypectomy surveillance colonoscopies.
Methods: This multicenter cross-sectional study included adults aged 40-80 years. Endoscopists (N = 96) who had performed ≥50 examinations were assessed for physician-related factors. Adenoma detection rate (ADR), adenomas per colonoscopy rate (APCR), advanced ADR, serrated polyp detection (SDR), and serrated polyps per colonoscopy rate (SPPCR) were calculated.
Results: We included 12,932 procedures, with 4810 carried out after a positive FIT and 1967 for surveillance. Of the 96 endoscopists evaluated, 43.8% were women, and the mean age was 41.9 years. The ADR, advanced ADR, and SDR were 39.7%, 17.7%, and 12.8%, respectively. Adenoma detection rate was higher in colonoscopies after a +FIT (50.3%) with a more than doubled advanced ADR compared to non-FIT procedures (27.6% vs. 13.0%) and similar results in serrated lesions (14.7% vs. 13.5%). Among all the detection indicators analyzed, withdrawal time was the only factor independently related to improvement (p < 0.001). Regarding FIT-positive and surveillance procedures, for both indications, withdrawal time was also the only factor associated with a higher detection of adenomas and serrated polyps (p < 0.001). Endoscopist-related factors (i.e., weekly hours dedicated to endoscopy, annual colonoscopy volume and lifetime number of colonoscopies performed) had also impact on lesion detection (APCR, advanced ADR and SPPCR).
Conclusions: Withdrawal time was the factor most commonly associated with improved detection of colonic lesions globally and in endoscopies for + FIT and post-polypectomy surveillance. Physician-related factors may help to address strategies to support training and service provision. Our results can be used for establishing future benchmarking and quality improvement in different colonoscopy indications.
(© 2022 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)
Databáze: MEDLINE
Externí odkaz: