title: The impact of fair colonoscopy preparation on colonoscopy use and adenoma miss rates in patients undergoing outpatient colonoscopy.
abstract: BACKGROUND
  The impact of fair bowel preparation on endoscopists' recommendations and adenoma miss rates in average-risk patients undergoing colonoscopy is unknown.
  
  
  OBJECTIVE
  To assess the impact of fair bowel preparation on endoscopists' interval colonoscopy recommendations and miss rates in colonoscopies performed within 3 years of the index colonoscopy in average-risk patients undergoing colorectal cancer screening.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Tertiary-care center.
  
  
  METHODS
  Average-risk patients undergoing index colonoscopy for colorectal cancer screening between 2004 and 2006.
  
  
  METHODS
  Colonoscopy.
  
  
  METHODS
  Endoscopists' interval recommendations, adenoma miss rates.
  
  
  RESULTS
  A total of 16,251 colonoscopy records were reviewed over a 2-year period. Of these cases, 1943 colonoscopies were performed for the sole indication of average risk or screening. Of these, fair bowel preparation was reported in 619 patients (31.9%). A repeat colonoscopy within 5 years was recommended in 70.4% of patients. The follow-up colonoscopy compliance rate within 3 years was 55.9%. Adenoma detection rates at index and follow-up colonoscopy were 20.5% and 28.2%, respectively. Of the 39 patients with follow-up colonoscopy within 3 years, the overall adenoma miss rate was 28%. Of the patients with an adenoma identified on follow-up colonoscopy, 13.6% had normal colonoscopy results on index examination.
  
  
  CONCLUSIONS
  Retrospective design.
  
  
  CONCLUSIONS
  Fair bowel preparation led to a deviation from national guidelines with early repeat colonoscopy follow-up recommendations in nearly 60% of average-risk patients with normal colonoscopy results. In patients who returned for repeat colonoscopy within 3 years, the overall adenoma miss rate was 28%. Further guidelines on timing for repeat colonoscopy for fair bowel preparation are needed.
authors: Division of Gastroenterology, University of Michigan Health System, Ann Arbor, Michigan, USA.
authors: Stacy B
authors: SB
authors: Menees
authors: H Myra
authors: HM
authors: Kim
authors: Eric E
authors: EE
authors: Elliott
authors: Jennifer L
authors: JL
authors: Mickevicius
authors: Brittany B
authors: BB
authors: Graustein
authors: Philip S
authors: PS
authors: Schoenfeld
mesh_terms: D000236:Adenoma / Q000175:diagnosis*; D002400:Cathartics / Q000008:administration & dosage; D003113:Colonoscopy / Q000592:standards; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003951:Diagnostic Errors; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D002400:Cathartics
keywords: CRC; colorectal cancer
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