QUALITY CRITERIA IN COLONOSCOPY – EXPERIENCE OF A PRIVATE TERTIARY CARE CENTER

Introduction Colorectal cancer (CRC) has seen an increase in incidence worldwide, being the third leading cause of cancer mortality in Brazil, in both sexes. The carcinogenesis of CRC is well-known, with adenomas being the precursor lesions in approximately 70% of cases, highlighting the importance of screening programs. Colonoscopy is the primary screening method, and quality criteria, such as the adenoma detection rate (ADR), must be met.

Objective To analyze the effectiveness of colonoscopy exams performed at a private tertiary care service by calculating the adenoma detection rate (ADR), serrated lesions, and advanced adenomas, and compare the results with the literature.

Method This was a retrospective observational study of colonoscopy exams performed at the Centro Médico de Campinas between January 1, 2018, and January 31, 2020. The ADR and advanced adenoma detection rate (AADR) were calculated, along with adjustments for sex, age range, and the indications for the exams. Also calculated were the total polyp detection rate (PDR), the hyperplastic polyp detection rate (HPDR), and the sessile serrated polyp detection rate (SSPDR).

Results A total of 3,686 colonoscopies were performed during the period, with 3,076 exams included in the analysis. The average age of the patients was 57.2 years, with the majority (53.5%) being female. Tubular adenoma was the most prevalent, found in 20% of the exams and in 62.7% of the exams with findings of any lesion. A total of 191 hyperplastic polyps and 61 serrated adenomas were described, together accounting for a quarter of the lesions in positive exams. The PDR was 23%, with a significant increase associated with age (p< 0.01). The ADR was 20%, significantly higher with age (p< 0.001) and higher in men (27%). The AADR was 4%, with a predominance of these in the distal segments. The HPDR was 6%, and the SSPDR was 2%.

Conclusion The adenoma detection rate, serrated lesions, and advanced adenoma rates were comparable with those in the literature. The polyp detection rate was higher in men and significantly increased with age. Tubular adenomas predominated, and distal segments of the colon were more commonly affected, with adenocarcinoma being rare.

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Artikel online veröffentlicht:
25. April 2025