Correlation between adenoma detection rate in colonoscopy- and fecal immunochemical testing-based colorectal cancer screening programs.
BACKGROUND
The adenoma detection rate (ADR) is the main quality indicator of colonoscopy. The ADR recommended in fecal immunochemical testing (FIT)-based colorectal cancer screening programs is unknown.


METHODS
Using the COLONPREV (NCT00906997) study dataset, we performed a post-hoc analysis to determine if there was a correlation between the ADR in primary and work-up colonoscopy, and the equivalent figure to the minimal 20% ADR recommended. Colonoscopy was performed in 5722 individuals: 5059 as primary strategy and 663 after a positive FIT result (OC-Sensor™; cut-off level 15 µg/g of feces). We developed a predictive model based on a multivariable lineal regression analysis including confounding variables.


RESULTS
The median ADR was 31% (range, 14%-51%) in the colonoscopy group and 55% (range, 21%-83%) in the FIT group. There was a positive correlation in the ADR between primary and work-up colonoscopy (Pearson's coefficient 0.716;p< 0.001). ADR in the FIT group was independently related to ADR in the colonoscopy group: regression coefficient for colonoscopy ADR, 0.71 (p= 0.009); sex, 0.09 (p= 0.09); age, 0.3 (p= 0.5); and region 0.00 (p= 0.9). The equivalent figure to the 20% ADR was 45% (95% confidence interval, 35%-56%).


CONCLUSIONS
ADR in primary and work-up colonoscopy of a FIT-positive result are positively and significantly correlated.
Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Instituto de Investigación Biomédica Ourense-Vigo-Pontevedra, Spain.
Joaquín
J
Cubiella
Department of Gastroenterology, Hospital Clínic, IDIBAPS, CIBERehd, Universitat de Barcelona, Spain.
Antoni
A
Castells
Department of Gastroenterology. Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Spain.
Montserrat
M
Andreu
Department of Gastroenterology, Hospital Donostia/Instituto Biodonostia, CIBERehd, Universidad del País Vasco (UPV/EHU), Spain.
Luis
L
Bujanda
Unidad de Gestión Clínica de Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB Arrixaca, Spain.
Fernando
F
Carballo
Gastroenterology Unit, Hospital General Universitario de Alicante, Spain.
Rodrigo
R
Jover
Department of Gastroenterology, Hospital Clínico Universitario de Zaragoza, CIBERehd, Spain.
Ángel
Á
Lanas
Department of Gastroenterology, Hospital Clínico Universitario San Carlos, Spain.
Juan Diego
JD
Morillas
Programa Poblacional de Cribado de Cáncer Colorrectal, Dirección General de Salud Pública, Conselleria de Sanitat, Spain.
Dolores
D
Salas
Department of Gastroenterology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
Enrique
E
Quintero
Colorectal adenoma; adenoma detection rate; colonoscopy; colorectal cancer screening; colorectal neoplasm; fecal immunochemical test