Observational studySurgical endoscopy2025
Dynamic adenoma detection rate influences the risk of metachronous advanced neoplasia after removal of low-risk findings in screening colonoscopy.
Observational study in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
backgroundEndoscopists' adenoma detection rate (ADR) may change over time and dynamic ADR has been identified as a predictor for post-screening colorectal cancer. However, whether low-risk findings removed by an endoscopist with a lower dynamic ADR benefit from a shorter duration of follow-up requires further research.
methodsWe conducted a two-center retrospective study of individuals who had low-risk findings removed and underwent subsequent surveillance colonoscopy. Endoscopists' dynamic ADR was the ADR of the previous 100 screening colonoscopies performed by the same endoscopist. A Cox-regression model and Kaplan-Meier survival analysis were used to explore the relationship between dynamic ADR and metachronous advanced colorectal neoplasia (ACRN).
resultsTotally, 3471 individuals who had low-risk findings removed in baseline colonoscopy were included in analysis. Decreasing endoscopists' dynamic ADR was independently associated with metachronous ACRN. A 3.97-, 2.21-, and 2.67-fold increased risk for metachronous ACRN was observed in individuals of which baseline colonoscopy was performed by an endoscopist with a dynamic ADR of < 15%, 15-19%, and 20-24%, respectively, compared with those with the highest dynamic ADR (≥ 25%). The cumulative incidence of metachronous ACRN reached the 5% threshold at 4.5 years, 7.3 years, and 6.2 years in the dynamic ADR < 15%, 15-19%, and 20-24% group, respectively.
conclusionEndoscopists' dynamic ADR influences the risk of metachronous ACRN after removal of low-risk findings in screening colonoscopy. Individuals undergoing removal of low-risk findings in screening colonoscopy by an endoscopist with a dynamic ADR < 25% may benefit from a shorter duration of follow-up interval.
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