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Interendoscopist variability in proximal colon polyp detection is twice higher for serrated polyps than adenomas
- Source :
- World Journal of Gastroenterology, World Journal of Gastroenterology, 2016, 22 (38), pp.8549--8557. ⟨10.3748/wjg.v22.i38.8549⟩, World Journal of Gastroenterology, Baishideng Publishing Group Co. Limited, 2016, 22 (38), pp.8549--8557. ⟨10.3748/wjg.v22.i38.8549⟩
- Publication Year :
- 2016
- Publisher :
- Baishideng Publishing Group Inc., 2016.
-
Abstract
- International audience; AIM To assess the interendoscopist variability in the detection of colorectal polyps according to their location and histological type. METHODS This study was a retrospective analysis of prospectively collected data from a regional colorectal cancer (CRC) screening program; 2979 complete colonoscopies from 18 endoscopists were included. Variability in performance between endoscopists for detection of at least one adenoma (A), one proximal adenoma (PA), one distal adenoma (DA), and one proximal serrated polyp (PSP) was assessed by using multilevel logistic regression models. RESULTS The observed detect ion rates among the 18 endoscopists ranged from 24.6% to 47.6% (mean = 35.7%) for A, from 19.1% to 39.0% (mean = 29.4%) for DA, from 6.0% to 22.9% (mean = 12.4%) for PA, and from 1.3% to 19.3% (mean = 6.9%) for PSP. After adjusting for patient-level variables (sex, age), the interendoscopist detection rates variability achieved a significant level for A, PA, and PSP but not for DA (P = 0.03, P = 0.02, P = 0.02 and P = 0.08, respectively). This heterogeneity, as measured by the variance partition coefficient, was approximately threefold higher for PA (6.6%) compared with A (2.1%), and twofold higher for PSP (12.3%) compared with PA. CONCLUSION These results demonstrate significant interendoscopist variability for proximal polyp particularly for serrated polyps, but not for distal adenoma detection. These findings contribute to explain the decreased effectiveness of complete colonoscopies at preventing proximal CRCs and the need to carefully assess the proximal colon during scope procedure.
- Subjects :
- Male
Databases, Factual
Proximal polyp
Colorectal cancer
population
Colonoscopy
Gastroenterology
lesions
0302 clinical medicine
Risk Factors
endoscopist
Medicine
Early Detection of Cancer
risk
Observer Variation
medicine.diagnostic_test
Serrated polyp
pathological conditions, signs and symptoms
General Medicine
Middle Aged
3. Good health
surgical procedures, operative
030220 oncology & carcinogenesis
Female
Quality performance
030211 gastroenterology & hepatology
withdrawal time
Colorectal Neoplasms
Observer variation
Adenoma
medicine.medical_specialty
prevalence
Colonic Polyps
screening colonoscopy
detection rates
03 medical and health sciences
Internal medicine
otorhinolaryngologic diseases
Humans
Retrospective Cohort Study
Proximal colon
neoplasms
Aged
Quality of Health Care
Retrospective Studies
[SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health
business.industry
polypectomy
colorectal-cancer
Reproducibility of Results
Detection rate
Endoscopy
Retrospective cohort study
medicine.disease
digestive system diseases
Cross-Sectional Studies
Logistic Models
business
Subjects
Details
- ISSN :
- 10079327
- Volume :
- 22
- Database :
- OpenAIRE
- Journal :
- World Journal of Gastroenterology
- Accession number :
- edsair.doi.dedup.....f862c3495c49f91cf086991e2ce8643c