Advanced adenoma detection rate is correlate more with adenoma per colonoscopy than adenoma detection rate

Abstract

Objectives: Although adenoma detection rate (ADR) has been proposed as a quality indicator of colonoscopy, adenoma per colonoscopy (APC) is considered to be the promising alternative to ADR as it reflects inspection over the entire length of the colon. The aim of this study was to investigate the correlation between ADR and APC among colonoscopist, and compare the efficacy of ADR and APC by investigating their relation with advanced adenoma detection rate (AADR).Methods: A total of 1142 consecutive participants undergoing screening colonoscopy at nine university hospitals by 28 colonoscopists were retrospectively reviewed. AADR 1 and 2 were defined as follows: (i); the proportion of participants having ≥1 advanced neoplasm (adenoma >10 mm in diameter; a tubulovillous or villous structure; high-grade dysplasia or cancer); and (ii): ≥1 advanced neoplasmor ≥3 adenomas. Spearman's rank-order correlation was used to evaluate the relationship between ADR–APC, ADR–AADR, and APC–AADR.Results: Among the 28 colonoscopists, the mean for ADR and APC was 37.29 ± 12.51 % and 0.65 ± 0.29, respectively. The ADRs ranged from 16.67% to 66.67%, and APCs ranged from 0.22 to 1. The ADR and APC showed significant correlation (R = 0.82; P < 0.001). The screening ADR with AADR1/AADR2 (R = 0.60; P = 0.001/R = 0.64; P < 0.001), and the APC with AADR1/AADR2 were both significantly correlated (R = 0.65; P < 0.001/R = 0.77; P < 0.001).Conclusions: Colonoscopists' ADR and APC were significantly correlated. Moreover, although both ADR and APC were correlated with AADR. correlation coefficient of AADR with APC was higher than with ADR. APC might be the better quality indicator of colonoscopy than ADR.