TY - JOUR
T1 - Impact of withdrawal time on adenoma detection rate
T2 - results from a prospective multicenter trial
AU - Desai, Madhav
AU - Rex, Douglas K.
AU - Bohm, Matthew E.
AU - Davitkov, Perica
AU - DeWitt, John M.
AU - Fischer, Monika
AU - Faulx, Gregory
AU - Heath, Ryan
AU - Imler, Timothy D.
AU - James-Stevenson, Toyia N.
AU - Kahi, Charles J.
AU - Kessler, William R.
AU - Kohli, Divyanshoo R.
AU - McHenry, Lee
AU - Rai, Tarun
AU - Rogers, Nicholas A.
AU - Sagi, Sashidhar V.
AU - Sathyamurthy, Anjana
AU - Vennalaganti, Prashanth
AU - Sundaram, Suneha
AU - Patel, Harsh
AU - Higbee, April
AU - Kennedy, Kevin
AU - Lahr, Rachel
AU - Stojadinovikj, Gjorgie
AU - Campbell, Carlissa
AU - Dasari, Chandra
AU - Parasa, Sravanthi
AU - Faulx, Ashley
AU - Sharma, Prateek
N1 - Publisher Copyright:
© 2023 American Society for Gastrointestinal Endoscopy
PY - 2023/3
Y1 - 2023/3
N2 - Background and Aims: Performing a high-quality colonoscopy is critical for optimizing the adenoma detection rate (ADR). Colonoscopy withdrawal time (a surrogate measure) of ≥6 minutes is recommended; however, a threshold of a high-quality withdrawal and its impact on ADR are not known. Methods: We examined withdrawal time (excluding polyp resection and bowel cleaning time) of subjects undergoing screening and/or surveillance colonoscopy in a prospective, multicenter, randomized controlled trial. We examined the relationship of withdrawal time in 1-minute increments on ADR and reported odds ratio (OR) with 95% confidence intervals. Linear regression analysis was performed to assess the maximal inspection time threshold that impacts the ADR. Results: A total of 1142 subjects (age, 62.3 ± 8.9 years; 80.5% men) underwent screening (45.9%) or surveillance (53.6%) colonoscopy. The screening group had a median withdrawal time of 9.0 minutes (interquartile range [IQR], 3.3) with an ADR of 49.6%, whereas the surveillance group had a median withdrawal time of 9.3 minutes (IQR, 4.3) with an ADR of 63.9%. ADR correspondingly increased for a withdrawal time of 6 minutes to 13 minutes, beyond which ADR did not increase (50.4% vs 76.6%, P < .01). For every 1-minute increase in withdrawal time, there was 6% higher odds of detecting an additional subject with an adenoma (OR, 1.06; 95% confidence interval, 1.02-1.10; P = .004). Conclusions: Results from this multicenter, randomized controlled trial underscore the importance of a high-quality examination and efforts required to achieve this with an incremental yield in ADR based on withdrawal time. (Clinical trial registration number: NCT03952611.)
AB - Background and Aims: Performing a high-quality colonoscopy is critical for optimizing the adenoma detection rate (ADR). Colonoscopy withdrawal time (a surrogate measure) of ≥6 minutes is recommended; however, a threshold of a high-quality withdrawal and its impact on ADR are not known. Methods: We examined withdrawal time (excluding polyp resection and bowel cleaning time) of subjects undergoing screening and/or surveillance colonoscopy in a prospective, multicenter, randomized controlled trial. We examined the relationship of withdrawal time in 1-minute increments on ADR and reported odds ratio (OR) with 95% confidence intervals. Linear regression analysis was performed to assess the maximal inspection time threshold that impacts the ADR. Results: A total of 1142 subjects (age, 62.3 ± 8.9 years; 80.5% men) underwent screening (45.9%) or surveillance (53.6%) colonoscopy. The screening group had a median withdrawal time of 9.0 minutes (interquartile range [IQR], 3.3) with an ADR of 49.6%, whereas the surveillance group had a median withdrawal time of 9.3 minutes (IQR, 4.3) with an ADR of 63.9%. ADR correspondingly increased for a withdrawal time of 6 minutes to 13 minutes, beyond which ADR did not increase (50.4% vs 76.6%, P < .01). For every 1-minute increase in withdrawal time, there was 6% higher odds of detecting an additional subject with an adenoma (OR, 1.06; 95% confidence interval, 1.02-1.10; P = .004). Conclusions: Results from this multicenter, randomized controlled trial underscore the importance of a high-quality examination and efforts required to achieve this with an incremental yield in ADR based on withdrawal time. (Clinical trial registration number: NCT03952611.)
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U2 - 10.1016/j.gie.2022.09.031
DO - 10.1016/j.gie.2022.09.031
M3 - Article
C2 - 36228700
AN - SCOPUS:85147234004
SN - 0016-5107
VL - 97
SP - 537-543.e2
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 3
ER -