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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(11): E1707-E1712
DOI: 10.1055/a-1244-1646
Original article

Adenoma detection rate as a quality indicator for colonoscopy: a descriptive cross-sectional study from a tertiary care hospital in Pakistan

Mian Shah Yousaf
1   Section of Gastroenterology, Department of Medicine, Aga Khan University, Karachi, Pakistan
,
Shameel Shafqat
2   Medical College, Aga Khan University, Karachi, Pakistan
,
Roger Christopher Gill
3   General Surgery, Department of Surgery, Aga Khan University, Karachi, Pakistan
,
Asfia Arham Khursheed
3   General Surgery, Department of Surgery, Aga Khan University, Karachi, Pakistan
,
Om Parkash
1   Section of Gastroenterology, Department of Medicine, Aga Khan University, Karachi, Pakistan
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Abstract

Background and study aims Adenoma detection rate (ADR) is validated for measuring quality of colonoscopy, however there is lack of colorectal cancer (CRC) screening program in South Asia. The purpose of this study is to analyze and review the polyp detection rate (PDR) and ADR and provide insight into the factors that influence them in Pakistan.

Patients and methods This retrospective, cross-sectional study was performed at the Aga Khan University Hospital, Karachi, Pakistan, on patients ≥ 18 years, who underwent colonoscopy between January 1, 2017 and June 30, 2018.

Results Of 1985 patients, 59 % were male and 41 % female, with mean age of 47.8 ± 16.2 years. The most common indication for colonoscopy was bleeding-per-rectum (28.0 %) and overall PDR and ADR were 17.9 % and 9.9 %, respectively. There was no significant difference between genders for either PDR (P = 0.378) or ADR (P = 0.574). Significantly higher PDR and ADR were found for patients ≥ 50 years (P < 0.001), as well as for suboptimal bowel preparation [PDR (25.7 %; P = 0.007) and ADR (18.6 %; P = 0.014)]. Interestingly, endoscopists with < 500 colonoscopy-procedural-experience reported a higher PDR (21.6 %; P = 0.020) and ADR (14.4 %; P = 0.049), corresponding to a significantly higher PDR (20.6 %; P = 0.005) and ADR (11.7 %; P = 0.02) for endoscopists in practice for ≤ 10 years.

Conclusions We have noticed low PDR and ADR, which require further investigation and research. In addition, we believe there should be a different baseline ADR and PDR as a quality indicator for colonoscopy in our region, where no internationally recommended colonoscopic screening programs have been implemented.



Publication History

Received: 09 March 2020

Accepted: 30 July 2020

Article published online:
22 October 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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