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CC BY 4.0 · Journal of Digestive Endoscopy 2024; 15(03): 169-173
DOI: 10.1055/s-0044-1789011
Research Article

Adenoma Detection Rate after Positive Stool-Based Screening in a U.S. Population

Thilini Delungahawatta 
1   Department of Medicine, MedStar Union Memorial Hospital, Baltimore, Maryland, United States
,
Richard Hum
2   Department of Medicine, Georgetown University School of Medicine, Washington, District of Columbia, United States
,
Stephanie M. Woo
3   Department of Gastroenterology, MedStar Georgetown University Hospital, Washington, District of Columbia, United States
,
Thomas Loughney
3   Department of Gastroenterology, MedStar Georgetown University Hospital, Washington, District of Columbia, United States
,
Joseph Jennings
3   Department of Gastroenterology, MedStar Georgetown University Hospital, Washington, District of Columbia, United States
› Author Affiliations Funding None declared.
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Abstract

Introduction and Objectives Over the past two decades, advancements in screening programs have led to a decrease in the incidence and mortality rates of colorectal cancer. The recommended benchmark for primary screening colonoscopy adenoma detection rate (ADR) is 25%. However, recent research supports higher ADR benchmarks following positive stool testing. Findings from a Dutch screening program have suggested higher ADRs in fecal immunochemical test positive patients with an inverse relationship with interval cancer development. Our study aims to assess ADRs in a U.S. patient population with positive stool screenings and investigate any correlation to occurrences of interval cancers.

Materials and Methods Data from all positive stool-based screening participants who subsequently underwent colonoscopy at a tertiary care center between 2017 and 2021 were collected. A retrospective chart review was performed to determine the ADR and interval colon cancers.

Results From a total of 120 patients (32 fecal occult blood test [FOBT] positive patients, 43 fecal immunochemical test [FIT] positive patients, 45 FIT-DNA-positive patients), the average ADR was 35%. Nonadvanced polyps were the most identified adenomas at 78.6%. No interval colorectal cancer cases were identified. There was a clear difference in ADR between stool-testing methods, with FIT-DNA showing higher ADRs than FIT and FOBT.

Conclusion Endoscopists should recognize the importance of higher ADR targets in colonoscopies conducted after positive stool-based screening as a means to maintain high-quality colonoscopy standards.

Keywords

adenoma detection rate - colonoscopy - colorectal cancer - colorectal neoplasms - stool-based screening

Previous Presentation

American College of Gastroenterology Annual Scientific Meeting in Vancouver, Canada in October 2023.


Statement of Ethics

Approval from the Institutional Review Board was obtained before conducting the chart review.


Author Contributions

T.D. was responsible for planning of the study, collecting and interpreting of data, as well as drafting and editing of the manuscript. R.H. was responsible for collecting data and drafting of the manuscript. S.M.W. was responsible for planning of the study, data analysis, as well as editing of the manuscript. T.L. and J.J. were involved with planning of the study and revision of manuscript. All the authors have approved the final draft of the manuscript submitted.




Publication History

Article published online:
27 August 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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