title: Differences in detection rates of adenomas and serrated polyps in screening versus surveillance colonoscopies, based on the new hampshire colonoscopy registry.
abstract: OBJECTIVE
  The adenoma detection rate (ADR) is an important quality indicator originally developed for screening colonoscopies. However, it is unclear whether the ADR should be calculated using data from screening and surveillance examinations. The recommended benchmark ADR for screening examinations is 20% (15% for women and 25% for men ≥50 y). There are few data available to compare ADRs from surveillance vs screening colonoscopies. We used a population-based registry to compare ADRs from screening vs surveillance colonoscopies. The serrated polyp detection rate (SDR), a potential new quality indicator, also was examined.
  
  
  METHODS
  By using data from the statewide New Hampshire Colonoscopy Registry, we excluded incomplete and diagnostic colonoscopies, and those performed in patients with inflammatory bowel disease, familial syndromes, or poor bowel preparation. We calculated the ADR and SDR (number of colonoscopies with at least 1 adenoma or serrated polyp detected, respectively, divided by the number of colonoscopies) from 9100 colonoscopies. The ADR and SDR were compared by colonoscopy indication (screening, surveillance), age at colonoscopy (50-64 y, ≥65 y), and sex.
  
  
  RESULTS
  The ADR was significantly higher in surveillance colonoscopies (37%) than screening colonoscopies (25%; P < .001). This difference was observed for both sexes and age groups. There was a smaller difference in the SDR of screening (8%) vs surveillance colonoscopies (10%; P < .001).
  
  
  CONCLUSIONS
  In a population-based study, we found that addition of data from surveillance colonoscopies increased the ADR but had a smaller effect on the SDR. These findings indicate that when calculating ADR as a quality measure, endoscopists should use screening, rather than surveillance colonoscopy, data.
authors: Department of Veterans Affairs Medical Center, White River Junction, Vermont; Department of Medicine, The Geisel School of Medicine at Dartmouth, Hanover, New Hampshire. Electronic address: joseph.anderson@dartmouth.edu.
authors: Joseph C
authors: JC
authors: Anderson
authors: Lynn F
authors: LF
authors: Butterly
authors: Martha
authors: M
authors: Goodrich
authors: Christina M
authors: CM
authors: Robinson
authors: Julia E
authors: JE
authors: Weiss
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D003113:Colonoscopy / Q000379:methods*; D055088:Early Detection of Cancer / Q000379:methods; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009513:New Hampshire; D011127:Polyps / Q000175:diagnosis* / Q000453:epidemiology; D012680:Sensitivity and Specificity
keywords: ADR; CI; CRC; Colon Cancer; Early Detection; Endoscopy; NHCR; New Hampshire Colonoscopy Registry; SDR; Tumor; adenoma detection rate; colorectal cancer; confidence interval; serrated polyp detection rate
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