Do Endoscopist Characteristics Impact Colonoscopy Polyp Detection Rates?
Posted: Tuesday, May 7, 2019
Characteristics of doctors performing colonoscopies, including their gender and medical speciality, do not impact the rate of detection of precancerous polyps. That’s the finding of a single-center retrospective study, published in JAMA Surgery, which counters earlier research suggesting certain endoscopist characteristics were associated with adenoma detection rates.
The study, conducted by the Cleveland Clinic health system, used data from 16,089 individuals who underwent screening colonoscopies between January 2015 and June 2017. The procedures were performed by 56 clinicians—60.7% were gastroenterologists, 26.5% were surgeons, and 12.5% were advanced endoscopists—with a median of 267 colonoscopies performed per year. Of the pool, 25% were women.
Researchers analyzing the data believed that previous studies did not adjust for certain risk factors associated with colonic neoplasia, and as such, they adjusted for a range of factors. Their findings showed that differences in adenoma detection rates associated with seven of seven endoscopist characteristics in previous studies, and differences in proximal sessile serrated polyp detection rates associated with five of seven endoscopist characteristics “may have been associated with residual confounding,” because they were not affirmed in the current study results.
Characteristics such as gender and medical speciality did not affect adenoma detection rates. However, doctors who had performed fewer colonoscopies or were further from their medical training had lower rates of proximal sessile serrated polyp detection. “Our findings reinforce the need for endoscopists to stay abreast of current resources to improve their detection and resection of sessile serrated polyps,” stated Carol A. Burke, MD, Vice Chair of the Department of Gastroenterology, Hepatology & Nutrition at the Cleveland Clinic.
The average adenoma detection rate was 31.3%, which is above the national standards suggested in guidelines from the American Society for Gastrointestinal Endoscopy and the American College of Gastroenterology.
Disclosure: The study authors reported no conflicts of interest.