title: Factors associated with adenoma detection rate and diagnosis of polyps and colorectal cancer during colonoscopy in France: results of a prospective, nationwide survey.
abstract: BACKGROUND
  Colonoscopy can prevent deaths due to colorectal cancer (CRC) through early diagnosis or resection of colonic adenomas. We conducted a prospective, nationwide study on colonoscopy practice in France.
  
  
  METHODS
  An online questionnaire was administered to 2,600 French gastroenterologists. Data from all consecutive colonoscopies performed during one week were collected. A statistical extrapolation of the results to a whole year was performed, and factors potentially associated with the adenoma detection rate (ADR) or the diagnosis of polyps or cancer were assessed.
  
  
  RESULTS
  A total of 342 gastroenterologists, representative of the overall population of French gastroenterologists, provided data on 3,266 colonoscopies, corresponding to 1,200,529 (95% CI: 1,125,936-1,275,122) procedures for the year 2011. The indication for colonoscopy was CRC screening and digestive symptoms in 49.6% and 38.9% of cases, respectively. Polypectomy was performed in 35.5% of cases. The ADR and prevalence of CRC were 17.7% and 2.9%, respectively. The main factors associated with a high ADR were male gender (p=0.0001), age over 50 (p=0.0001), personal or family history of CRC or colorectal polyps (p<0.0001 and p<0.0001, respectively), and positive fecal occult blood test (p=0.0005). The prevalence of CRC was three times higher in patients with their first colonoscopy (4.2% vs. 1.4%; p<0.0001).
  
  
  CONCLUSIONS
  For the first time in France, we report nationwide prospective data on colonoscopy practice, including histological results. We found an average ADR of 17.7%, and observed reduced CRC incidence in patients with previous colonoscopy.
authors.affiliation: Department of Gastroenterology and Digestive Endoscopy, George Pompidou European Hospital and Faculté Paris Descartes, Paris, France.
authors.forename: Maximilien
authors.initials: M
authors.lastname: Barret
authors.forename: Christian
authors.initials: C
authors.lastname: Boustiere
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Canard
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Arpurt
authors.forename: David
authors.initials: D
authors.lastname: Bernardini
authors.forename: Philippe
authors.initials: P
authors.lastname: Bulois
authors.forename: Stanislas
authors.initials: S
authors.lastname: Chaussade
authors.forename: Denis
authors.initials: D
authors.lastname: Heresbach
authors.forename: Isabelle
authors.initials: I
authors.lastname: Joly
authors.forename: Jean
authors.initials: J
authors.lastname: Lapuelle
authors.forename: René
authors.initials: R
authors.lastname: Laugier
authors.forename: Gilles
authors.initials: G
authors.lastname: Lesur
authors.forename: Patrice
authors.initials: P
authors.lastname: Pienkowski
authors.forename: Thierry
authors.initials: T
authors.lastname: Ponchon
authors.forename: Bertrand
authors.initials: B
authors.lastname: Pujol
authors.forename: Bruno
authors.initials: B
authors.lastname: Richard-Molard
authors.forename: Michel
authors.initials: M
authors.lastname: Robaszkiewicz
authors.forename: Rémi
authors.initials: R
authors.lastname: Systchenko
authors.forename: Fatima
authors.initials: F
authors.lastname: Abbas
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Schott-Pethelaz
authors.forename: Christophe
authors.initials: C
authors.lastname: Cellier
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D000367:Age Factors; D000368:Aged; D003113:Colonoscopy / Q000379:methods / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D005762:Gastroenterology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians; D011127:Polyps / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012737:Sex Factors; D011795:Surveys and Questionnaires