CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(07): E878-E884
DOI: 10.1055/a-0605-3264
Original article
Owner and Copyright © Georg Thieme Verlag KG 2018

Number of polyps detected is a useful indicator of quality of clinical colonoscopy

Takahiro Amano
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
,
Tsutomu Nishida
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
,
Hiromi Shimakoshi
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
,
Akiyoshi Shimoda
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
,
Naoto Osugi
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
,
Aya Sugimoto
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
,
Kei Takahashi
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
,
Kaori Mukai
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
,
Dai Nakamatsu
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
,
Tokuhiro Matsubara
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
,
Masashi Yamamoto
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
,
Shiro Hayashi
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
,
Sachiko Nakajima
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
,
Koji Fukui
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
,
Masami Inada
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka, Japan
› Author Affiliations
Further Information

Publication History

submitted 13 December 2017

accepted after revision 12 March 2018

Publication Date:
04 July 2018 (online)

Abstract

Background and study aims Adenoma detection rate (ADR) is a well-known quality indicator (QI) for colonoscopy. It is, however, difficult to evaluate ADR during practice. The aim of this study was to investigate the number of endoscopically detected polyps as a QI for colonoscopy.

Patients and methods This was a retrospective single-center cohort study of 5,190 consecutive patients who underwent colonoscopy from January 2015 to May 2016. Among these patients, we ultimately enrolled 1,937 patients for initial colonoscopy. We evaluated QIs including bowel preparation, cecum intubation time, withdrawal time, number of endoscopically detected polyps, ADR and advanced neoplasia detection rate (ANDR)

Results The mean number of endoscopically detected polyps, ADR and ANDR were 1.5 ± 2.3 (95 % confidence interval (CI)1.4 – 1.6), 38.6 % (95 % CI 36.5-40.8), and 18.3 % (95 % CI 16.6 – 20.1), respectively. ADR and ANDR increased with the number of endoscopically detected polyps, but the correlation reached a plateau at five or more polyps. We divided the patients into three groups based on the number of polyps (1 to 2, 3 to 4, and 5 or more). Logistic regression analysis adjusted by age and sex revealed that presence of a large number of polyps was a strong predictor of advanced neoplasia (odds ratio: 3.1 [95 % CI 2.2 – 4.3] for 3 to 4 polyps and 7.9 [95 % CI 5.4 – 11.8] for 5 or more polyps when using the presence of 1 or 2 polyps as a reference).

Conclusion The number of endoscopically detected polyps can predict risk of advanced neoplasia and may thus be a new QI for colonoscopy.