KMID : 0614620140640010018
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Korean Journal of Gastroenterology 2014 Volume.64 No. 1 p.18 ~ p.23
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Correlation between Adenoma Detection Rate and Advanced Adenoma Detection Rate
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Lee Shin-Yeong
Kim Nam-Hee Chae Hyun-Beom Han Ki-Joong Lee Tae-Hoon Jang Cheol-Min Yoo Kyung-Mo Jung Yoon-Suk Park Jung-Ho Kim Hong-Joo Cho Yong-Kyun Sohn Chong-Il Jeon Woo-Kyu Kim Byung-Ik Park Dong-Il
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Abstract
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Background/Aims: Adenoma detection rate (ADR) is widely used as an index of colonoscopy quality management. Although advanced adenomas can be found less frequently than non-advanced adenomas, advanced adenomas have a higher clinical significance during screening for colorectal cancer. The aim of this study was to investigate the correlation between advanced and non-advanced ADR among colonoscopists.
Methods: This study is an observational study of a cohort of patients undergoing screening colonoscopy between 2009 and 2010. We collected the data on patients¡¯ characteristics and colonoscopic findings. The detection rates of adenoma and advanced adenoma were calculated. Logistic regression was used to determine the effects of variables on advanced adenoma detection, and spearman¡¯s rank-order correlation was used to evaluate the relationship between advanced ADR and ADR.
Results: A total of 561 patients underwent screening colonoscopy by 18 experienced colonoscopists. Most colonoscopists had adequate (£¾20%) ADRs. Logistic regression showed that increased patient age (OR 1.07 per 1 year increase, 95% CI 1.009-1.133, p=0.023) and male gender (OR 1.860, 95% CI 0.764-4.529, p=0.171) were associated with advanced ADR. When colonoscopists were divided into two groups on the basis of advanced ADR of 5%, ADR was also significantly higher in the group having higher level of advanced ADR. However, there was no correlation between advanced ADR and ADR among colonoscopists as an individual.
Conclusions: Colonoscopists¡¯ advanced ADRs were independent of their ADRs, indicating that advanced ADR could be quite low even among colonoscopists with acceptable ADRs. Thus, there seems to be a limitation in using ADR as an adequate index of colonoscopy quality management.
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KEYWORD
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Adenoma, Colonoscopy, Colorectal neoplasms, Early detection of cancer
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