title: Differences in proximal serrated polyp detection among endoscopists are associated with variability in withdrawal time.
abstract: BACKGROUND
  Insufficient detection of proximal serrated polyps (PSP) might explain the occurrence of a proportion of interval carcinomas in colonoscopy surveillance programs.
  
  
  OBJECTIVE
  To compare PSP detection among endoscopists and to identify patient-related and endoscopist-related factors associated with PSP detection.
  
  
  METHODS
  Prospective study in unselected patients.
  
  
  METHODS
  Colonoscopy screening program for colorectal cancer at two academic medical centers.
  
  
  METHODS
  Asymptomatic consecutive screening participants (aged 50-75 years).
  
  
  METHODS
  Colonoscopies were performed by 5 experienced endoscopists. All detected polyps were removed. Multiple colonoscopy quality indicators were prospectively recorded.
  
  
  METHODS
  We compared PSP detection among endoscopists by calculating odds ratios (OR) with logistic regression analysis. Logistic regression also was used to identify patient features and colonoscopy factors associated with PSP detection.
  
  
  RESULTS
  A total of 1354 patients underwent a complete screening colonoscopy: 1635 polyps were detected, of which 707 (43%) were adenomas and 685 (42%) were serrated polyps, including 215 PSPs. In 167 patients (12%) 1 or more PSPs were detected. The PSP detection rate differed significantly among endoscopists, ranging from 6% to 22% (P < .001). Longer withdrawal time (OR 1.12; 95% confidence interval, 1.10-1.16) was significantly associated with better PSP detection, whereas patient age, sex, and quality of bowel preparation were not.
  
  
  CONCLUSIONS
  Limited number of highly experienced endoscopists.
  
  
  CONCLUSIONS
  The PSP detection rate differs among endoscopists. Longer withdrawal times are associated with better PSP detection, but patient features are not. (
  
  
  BACKGROUND
  NTR1888.).
authors: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
authors: Thomas R
authors: TR
authors: de Wijkerslooth
authors: Esther M
authors: EM
authors: Stoop
authors: Patrick M
authors: PM
authors: Bossuyt
authors: Kristien M A J
authors: KM
authors: Tytgat
authors: Jan
authors: J
authors: Dees
authors: Elisabeth M H
authors: EM
authors: Mathus-Vliegen
authors: Ernst J
authors: EJ
authors: Kuipers
authors: Paul
authors: P
authors: Fockens
authors: Monique E
authors: ME
authors: van Leerdam
authors: Evelien
authors: E
authors: Dekker
mesh_terms: D000236:Adenoma / Q000473:pathology*; D000368:Aged; D003111:Colonic Polyps / Q000473:pathology*; D003113:Colonoscopy / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D013997:Time Factors