Does Increased Adenoma Detection Reduce the Risk of Colorectal Cancer, and How Good Do We Need to Be?

Current Gastroenterology Reports
Christen K Dilly, Charles J Kahi

Abstract

Colorectal cancer (CRC) is largely preventable with colonoscopy and other screening modalities. However, the effectiveness of screening and surveillance depends on the quality of the colonoscopy exam. Adenoma detection rate (ADR) is the best-validated metric by which we measure individual physicians' performance. Recent evidence suggests that ADR benchmarks may be inappropriately low. There is proof that improving ADR leads to significant reductions in post-colonoscopy CRC (PCCRC). Two studies have demonstrated that when a colonoscopy is performed by physicians with higher ADRs, patients are less likely to have advanced adenomas on surveillance and less likely to develop or die from PCCRC. Finally, there is at least some evidence that higher ADRs do not lead to more cumulative surveillance exams. The ADR is a useful outcome measure that can provide individual endoscopists and their patients with information about the likelihood of developing PCCRC. To achieve the lowest possible PCCRC rate, we should be striving for higher ADRs. While strategies and innovations may help a bit in improving ADRs, our efforts should focus on ensuring a complete mucosal exam for each patient. Behavioral psychology theories may provide useful framew...Continue Reading

References

Jan 8, 2000·Journal of Personality and Social Psychology·J Kruger, D Dunning
Feb 5, 2005·Quality & Safety in Health Care·S MichieUNKNOWN "Psychological Theory" Group
Apr 26, 2006·The American Journal of Gastroenterology·Douglas K RexUNKNOWN ASGE/ACG Taskforce on Quality in Endoscopy
Jun 15, 2006·The American Journal of Gastroenterology·Dorte Ejg JarbolOve B Schaffalitzky de Muckadell
Jul 22, 2008·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Robert L BarclayRoger L Greenlaw
Jan 13, 2010·Journal of the National Comprehensive Cancer Network : JNCCN·David G HewettDouglas K Rex
May 14, 2010·The New England Journal of Medicine·Michal F KaminskiEugeniusz Butruk
Feb 24, 2012·The New England Journal of Medicine·Ann G ZauberJerome D Waye
May 15, 2012·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Susan G CoeMassimo Raimondo
Jan 9, 2013·The American Journal of Gastroenterology·Susan G CoeMichael B Wallace
Mar 12, 2013·Gastrointestinal Endoscopy·Charles J KahiCynthia S Johnson
Jun 8, 2013·Gut·Chantal M C le ClercqSilvia Sanduleanu
Jun 25, 2013·Gut·Douglas J RobertsonMaría Elena Martínez
Apr 4, 2014·The New England Journal of Medicine·Douglas A CorleyCharles P Quesenberry
Sep 7, 2014·Gut·S SanduleanuUNKNOWN Expert Working Group on ‘Right-sided lesions and interval cancers’, Colorectal Cancer Screening Committee, World Endoscopy O
Dec 7, 2014·Gastrointestinal Endoscopy·Douglas K RexDavid S Weinberg
Mar 4, 2015·The American Journal of Gastroenterology·Vladimir M KushnirDayna S Early
May 27, 2015·The Cochrane Database of Systematic Reviews·Susanne HafnerOliver Zolk
Dec 7, 2016·World Journal of Gastroenterology : WJG·Matthew ChinDouglas L Nguyen
Mar 2, 2017·CA: a Cancer Journal for Clinicians·Rebecca L SiegelAhmedin Jemal
Apr 22, 2017·Gastroenterology·Michal F KaminskiJaroslaw Regula
Aug 27, 2017·Best Practice & Research. Clinical Gastroenterology·Douglas K Rex
Sep 4, 2017·Gastrointestinal Endoscopy·Ateev MehrotraRobert E Schoen
Mar 3, 2018·Surgical Oncology Clinics of North America·John F Sullivan, John A Dumot
Jun 9, 2018·United European Gastroenterology Journal·Carolina Mangas-SanjuanUNKNOWN COLONPREV study investigators
Dec 12, 2018·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Antonio FacciorussoSiddharth Singh

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