ArticleThe American journal of gastroenterology2016
Defining Benchmarks for Adenoma Detection Rate and Adenomas Per Colonoscopy in Patients Undergoing Colonoscopy Due to a Positive Fecal Immunochemical Test.
Article in The American journal of gastroenterology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
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- Randomized Clinical Trial: A Normocaloric Low-Fiber Diet the Day Before Colonoscopy Is the Most Effective Approach to Bowel Preparation in Colorectal Cancer Screening Colonoscopy.Diseases of the colon and rectum · 2019Trial
- Interval Colorectal Cancers in a Fecal Immunochemical Test-Based Screening Program.JAMA network open · 2025Article
- Which is the better polyp detection metric: adenomas per colonoscopy or adenoma detection rate? A simulation modeling study.Endoscopy international open · 2024Article
- Quality Indicators for Colonoscopy.The American journal of gastroenterology · 2024Article
- Adenoma detection rate is enough to assess endoscopist performance: a population-based observational study of FIT-positive colonoscopies.Endoscopy international open · 2022Article
- Impact of screening and follow-up colonoscopy adenoma sensitivity on colorectal cancer screening outcomes in the CRC-AIM microsimulation model.Cancer medicine · 2021Article
- Colonoscopy Quality and Adherence to Postpolypectomy Surveillance Guidelines in an Underinsured Clinic System.Gastroenterology research and practice · 2020Article
- Standards of diagnostic colonoscopy for early-stage neoplasia: Recommendations by an Asian private group.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2019Article
- Does Increased Adenoma Detection Reduce the Risk of Colorectal Cancer, and How Good Do We Need to Be?Current gastroenterology reports · 2019Review
- Alberta Family Physician Electronic Endoscopy study: Quality of 1769 colonoscopies performed by rural Canadian family physicians.Canadian family physician Medecin de famille canadien · 2018Article
- Adenoma detection rate metrics in colorectal cancer surveillance colonoscopy.Surgical endoscopy · 2018Article
- Adenoma Detection Rate in Asymptomatic Patients with Positive Fecal Immunochemical Tests.Digestive diseases and sciences · 2018Article
- Impact of differences in adenoma and proximal serrated polyp detection rate on the long-term effectiveness of FIT-based colorectal cancer screening.BMC cancer · 2018Article
- Colorectal Cancer Screening in Asia.Current gastroenterology reports · 2017Review
- Article
- Colorectal Cancer Screening Among Métis and Non-Métis Males and Females in Alberta, Canada.Cancer control : journal of the Moffitt Cancer CenterArticle
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAlthough there is an accepted benchmark for adenoma detection rate (ADR) in average risk screening colonoscopy, a benchmark for ADR or the associated quality indicator, adenomas per colonoscopy (APC), for colonoscopies performed for a positive fecal immunochemical test (FIT+) has not been established. The purpose of this study was to propose methods for establishing a benchmark ADR and APC for FIT+ patients.
methodsIn this historical cohort study, we included 15,329 patients aged 50-74 years who underwent a colonoscopy at Alberta Health Services' Colon Cancer Screening Centre, Calgary, Canada, from 1 January 2014 to 30 June 2015 for either investigation of a positive FIT or average risk screening. Using meta-regression, we estimated for FIT+ patients the ADR and APC that corresponded to (Method #1: minimally acceptable) an ADR of 25% in average risk individuals, (Method #2: standard of care) the average ADR or APC in all FIT+ patients, and (Method #3: aspirational) the average FIT+ ADR or APC in colonoscopies performed by endoscopists with an ADR of ≥35% in average risk patients.
resultsAt least one adenoma was detected in 30% of average risk patients and 58% of FIT+ patients. The calculated benchmark FIT+ ADRs for the three methods were 55, 60, and 65%, respectively. The calculated benchmarks for FIT+ APC were 1.2, 1.4, and 1.7, respectively. To account for expected random variation in individual endoscopists' ADR or APC, we propose using the upper bound of the 95% confidence interval of an endoscopist's ADR or APC to determine if they fall below a given benchmark.
conclusionsWe have proposed methods of defining benchmarks for ADR and APC in FIT+ patients that go beyond the current "minimally acceptable" threshold currently recommended in average risk patients. These new thresholds represent results obtained by all peers and by a group of expert adenoma detectors defined in an independent patient cohort (average risk). Because the true adenoma burden in FIT+ patients could vary based on factors such as the threshold used to define a positive FIT, screening programs or endoscopy units may need to calculate their own benchmarks using local data.
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