title: Screening polypectomy rates below quality benchmarks: a prospective study.
abstract: OBJECTIVE
  To estimate and compare sex-specific screening polypectomy rates to quality benchmarks of 40% in men and 30% in women.
  
  
  METHODS
  A prospective cohort study was undertaken of patients aged 50-75, scheduled for colonoscopy, and covered by the Québec universal health insurance plan. Endoscopist and patient questionnaires were used to obtain screening and non-screening colonoscopy indications. Patient self-report was used to obtain history of gastrointestinal conditions/symptoms and prior colonoscopy. Sex-specific polypectomy rates (PRs) and 95%CI were calculated using Bayesian hierarchical logistic regression.
  
  
  RESULTS
  In total, 45 endoscopists and 2134 (mean age = 61, 50% female) of their patients participated. According to patients, screening PRs in males and females were 32.4% (95%CI: 23.8-41.8) and 19.4% (95%CI: 13.1-25.4), respectively. According to endoscopists, screening PRs in males and females were 30.2% (95%CI: 27.0-41.9) and 16.6% (95%CI: 16.3-28.6), respectively. Sex-specific PRs did not meet quality benchmarks at all ages except for: males aged 65-69 (patient screening indication), and males aged 70-74 (endoscopist screening indication). For all patients aged 50-54, none of the CI included the quality benchmarks.
  
  
  CONCLUSIONS
  Most sex-specific screening PRs in Québec were below quality benchmarks; PRs were especially low for all 50-54 year olds.
authors.affiliation: Maida J Sewitch, Alan Barkun, Department of Medicine, McGill University, Montréal, Québec H3G 1Y6, Canada.
authors.forename: Maida J
authors.initials: MJ
authors.lastname: Sewitch
authors.affiliation: Maida J Sewitch, Alan Barkun, Department of Medicine, McGill University, Montréal, Québec H3G 1Y6, Canada.
authors.forename: Mengzhu
authors.initials: M
authors.lastname: Jiang
authors.affiliation: Maida J Sewitch, Alan Barkun, Department of Medicine, McGill University, Montréal, Québec H3G 1Y6, Canada.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Fon Sing
authors.affiliation: Maida J Sewitch, Alan Barkun, Department of Medicine, McGill University, Montréal, Québec H3G 1Y6, Canada.
authors.forename: Alan
authors.initials: A
authors.lastname: Barkun
authors.affiliation: Maida J Sewitch, Alan Barkun, Department of Medicine, McGill University, Montréal, Québec H3G 1Y6, Canada.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Joseph
mesh_terms: D000367:Age Factors; D000368:Aged; D001499:Bayes Theorem; D019985:Benchmarking / Q000592:standards*; D003082:Colectomy / Q000592:standards*; D003111:Colonic Polyps / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy / Q000592:standards*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D019983:Guideline Adherence; D054624:Health Status Disparities; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000592:standards*; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019984:Quality Indicators, Health Care / Q000592:standards*; D011792:Quebec; D012737:Sex Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Benchmarking; Colonoscopy; Colorectal cancer; Quality assurance; Screening