Adenoma Detection Rate Tied to CRC Risk After Positive FIT

TUESDAY, Sept. 27, 2022 (HealthDay News) — The adenoma detection rate (ADR) of endoscopists is associated with the risk for interval postcolonoscopy colorectal cancers (PCCRCs) after a positive fecal immunochemical testing (FIT) result, according to a study published online Sept. 27 in the Annals of Internal Medicine.

Pieter H.A. Wisse, M.D., from the Erasmus University Medical Center in Rotterdam, Netherlands, and colleagues examined the association between the ADR and PCCRC risk in colonoscopies performed after a positive FIT result in a population-based cohort study. PCCRCs were classified as interval, in which a cancer was detected before recommended surveillance, or noninterval.

A total of 362 endoscopists performed 116,360 colonoscopies, with a median ADR of 67 percent. The researchers identified 209 interval PCCRCs. The ADR was associated with interval PCCRC; for each 1 percent increase in ADR, there was an adjusted hazard ratio of 0.95. The expected number of interval PCCRC diagnoses after five years was about 2.0 per 1,000 patients undergoing colonoscopy for endoscopists with ADRs of 70 percent compared with more than 2.5, almost 3.5, and more than 4.5 for those with ADRs of 65, 60, and 55 percent, respectively.

“This supports the use of ADR as an important quality indicator for endoscopists performing colonoscopy in all CRC screening programs,” the authors write. “Based on the outcome of this study, the ADR target for endoscopists performing colonoscopy after a positive FIT result should be increased.”

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