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Interendoscopist variability in proximal colon polyp detection is twice higher for serrated polyps than adenomas

World Journal of Gastroenterology 2016年第38期22卷 8549-8557页

作者： jean-françois Bretagne Stéphanie Hamonic Christine Piette jean-françois viel Guillaume Bouguen Service des maladies de l'appareil digestif hopital PontchaillouCentre hospitalo-universitaire de Rennes35033 RennesFrance Service d'épidémiologie et de santé publique Centre hospitalo-universitaire de Rennes35033 Rennes France Association pour le dépistage des cancers en Ille et Vilaine 35033 RennesFrance

AIM To assess the interendoscopist variability in the detection of colorectal polyps according to their location and histological *** This study was a retrospective analysis of prospectively collected data from a regional colorectal cancer(CRC) screening program; 2979 complete colonoscopies from 18 endoscopists were included. Variability in performance between endoscopists for detection of at least one adenoma(A), one proximal adenoma(PA), one distal adenoma(DA), and one proximal serrated polyp(PSP) was assessed by using multilevel logistic regression *** The observed detection rates among the 18 endoscopists ranged from 24.6% to 47.6%(mean = 35.7%) for A, from 19.1% to 39.0%(mean = 29.4%) for DA, from 6.0% to 22.9%(mean = 12.4%) for PA, and from 1.3% to 19.3%(mean = 6.9%) for *** adjusting for patient-level variables(sex, age), the interendoscopist detection rates variability achieved a significant level for A, PA, and PSP but not for DA(P = 0.03, P = 0.02, P = 0.02 and P = 0.08, respectively). This heterogeneity, as measured by the variance partition coefficient, was approximately threefold higher for PA(6.6%) compared with A(2.1%), and twofold higher for PSP(12.3%) compared with *** These results demonstrate significant interendoscopist variability for proximal polyp particularly for serrated p o l y p s, b u t n o t f o r d i s t a l a d e n o m a d e t e c t i o n. These findings contribute to explain the decreased effectiveness of complete colonoscopies at preventing proximal CRCs and the need to carefully assess the proximal colon during scope procedure.

关键词： Colonoscopy Colorectal cancer Adenoma Serrated polyp Proximal polyp Detection rate Quality performance

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