A higher adenoma detection rate is associated with increased detection of colorectal cancer during screening colonoscopies, demonstrating that CRC incidence and mortality after index colonoscopy result not only from missed precancerous lesions but also from missed cancers, according to an analysis of the GI Quality Improvement Consortium (GIQuIC) database.
“We saw that ADR is associated with the detection of [advanced adenomas (AAs)] and [sessile serrated lesions (SSLs)], but that’s not terribly surprising. What was somewhat surprising was the difference in the cancer detection rate,” said lead author Jason A. Dominitz, MD, MHS, the national director of gastroenterology for the Veterans Health Administration and a professor of gastroenterology and medicine at the University of Washington, Seattle, who presented the findings at Digestive Disease Week 2023 (abstract Sa1067). Dr. Dominitz noted that endoscopists in the highest ADR quintile (>48%) detected 29% more CRCs than those in the lowest quintile.
“While well-established data support ADR as a quality metric inversely associated with the development of post-colonoscopy colorectal cancer, this is the first study to show an association with the detection of colorectal cancer during colonoscopy,” commented Trilokesh Kidambi, MD, a gastroenterologist and the director of the colon cancer screening program at City of Hope, in Duarte, Calif, who was not involved in the study.