ArticleBMC gastroenterology2024
The impact of endoscopist performance and patient factors on distal adenoma detection and colorectal cancer incidence.
Article in BMC gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Artificial Intelligence-Assisted Colonoscopy for Colorectal Lesion Detection: Current Evidence, Challenges, and Future Directions.Journal of clinical medicine · 2026Review
- Artificial intelligence-assisted colonoscopy for colorectal lesion detection: a case-control study on diagnostic accuracy and histopathological agreement.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2025Article
- The impact of endoscopist performance and patient factors on distal adenoma detection and colorectal cancer incidence.BMC gastroenterology · 2024Article
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Authors and funding
4 authors.
Funding
Abstract
backgroundHigh quality endoscopy is key for detecting and removing precursor lesions to colorectal cancer (CRC). Adenoma detection rates (ADRs) measure endoscopist performance. Improving other components of examinations could increase adenoma detection.
aimsTo investigate how endoscopist performance at flexible sigmoidoscopy (FS) affects adenoma detection and CRC incidence.
methodsAmong 34,139 participants receiving FS screening by the main endoscopist at one of 13 centres in the UK FS Screening Trial, median follow-up was 17 years. Factors examined included family history of CRC, bowel preparation quality, insertion and withdrawal time, bowel segment reached, patient pain and ADR. Odds ratios (OR) for distal adenoma detection were estimated by logistic regression. Hazard ratios (HR) for distal CRC incidence were estimated by Cox regression.
resultsAt screening, 4,104 participants had distal adenomas detected and 168 participants developed distal CRC during follow-up. In multivariable models, a family history of CRC (yes vs. no: OR 1.40, 95%CI 1.21-1.62), good or adequate bowel preparation quality (vs. excellent: OR 0.84, 95%CI 0.74-0.95; OR 0.56, 95%CI 0.49-0.65, respectively) and longer insertion and withdrawal times (≥ 4.00 vs. < 2.00 min: OR 1.96, 95%CI 1.68-2.29; OR 32.79, 95%CI 28.22-38.11, respectively) were associated with adenoma detection. Being screened by endoscopists with low or intermediate ADRs, compared to high ADRs, was positively associated with CRC incidence (multivariable: HR 4.71, 95%CI 2.65-8.38; HR 2.16, 95%CI 1.22-3.81, respectively).
conclusionsBowel preparation quality and longer insertion and withdrawal time are key for improving distal adenoma detection. Higher ADRs were associated with a lower risk of distal CRC.
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