title: Neoplasia detection rates after positive fecal occult blood test results are not affected by endoscopy center: a population-based study.
abstract: BACKGROUND
  We previously showed a significant variability in adenoma detection among colonoscopists who were participating in a mass screening program. The reasons for such variability remain largely unknown.
  
  
  OBJECTIVE
  To study intercenter variations in neoplasia detection.
  
  
  METHODS
  Secondary analyses of colonoscopy findings from the 2 first rounds of a French screening program: logistic regressions and repeated-measures analyses of variance.
  
  
  METHODS
  A total of 3487 colonoscopies performed by all 19 endoscopists who performed 30 examinations or more per round at 8 centers (6 private, 2 public).
  
  
  METHODS
  Probabilities of detecting 1, 2, or 3 or more adenomas, 1 adenoma 10 mm or larger, or colorectal cancer, as well as the corresponding adjusted (for patient age and sex) per-center detection rates.
  
  
  RESULTS
  Endoscopy centers were not significant predictors of the probability of detecting any category of neoplasia with the exception of the 2 adenomas or more category (P < .005). The ranges of the adjusted detection rates for each of these categories were 33.1% to 43.1%, 11.1% to 21.6%, 3.6% to 8.1%, 16.3% to 23.6%, and 8.3% to 12.6%, respectively. When the colonoscopies that were performed by the 11 endoscopists who performed 30 examinations or more per center in 2 or more centers were separately analyzed, no intercenter statistically significant variability was observed with the exception of 1 endoscopist and the 1 adenoma category. In a subgroup of 1100 colonoscopies performed by 6 endoscopists who were working at the same 3 centers, intercenter variability was not statistically significant.
  
  
  CONCLUSIONS
  Type II error because of sample sizes.
  
  
  CONCLUSIONS
  In our setting, intercenter variability did not explain interendoscopist variability for neoplasia detection rate.
authors.affiliation: Department of Gastroenterology, Pontchaillou Hospital, Rennes, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Bretagne
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Hamonic
authors.forename: Christine
authors.initials: C
authors.lastname: Piette
authors.forename: Sylvain
authors.initials: S
authors.lastname: Manfredi
authors.forename: Gaud
authors.initials: G
authors.lastname: Mallard
authors.forename: Gérard
authors.initials: G
authors.lastname: Durand
authors.forename: Françoise
authors.initials: F
authors.lastname: Riou
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000453:epidemiology*; D000368:Aged; D000704:Analysis of Variance; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D005602:France; D006268:Health Facilities / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009780:Occult Blood