Hashim, Mohd Badrul Hisyam and Nik Muhamad Affendi, Nik Arsyad and Ho, Shiaw Hooi
(2023)
Factors associate with high adenoma detection rate: a tertiary centre experience.
In: GUT 2023, Kuala Lumpur.
Abstract
NTRODUCTION: Colorectal cancer (CRC) is the leading cancer among men and the second leading cancer among women
in Malaysia. Colonoscopy is a gold standard modality for screening of CRC because it allows complete examination of the
colon for the detection of cancerous and pre-cancerous lesions. Adenoma detection rate (ADR) is considered as one of the
key indicators of high-quality colonoscopy. We sought to determine ADR in our centre and factors that associate with high
ADR.
METHODOLOGY: This was a retrospective analysis of consecutive colonoscopy performed in our centre over 1-year
duration from January 2019 to December 2019. Overall, 1,761 adult patients aged 18-years-old and above who underwent
colonoscopy for symptomatic examination, screening and surveillance were included. The data was collected from
the endoscopy registry in Electronic Medical Record system. Baseline characteristic of the study population, ADR and
endoscopist data were collected and analysed. All the data were compiled and analysed using SPSS 26.
RESULT: Baseline characteristic of study population is as shown in table 1. A total of 51 endoscopists performed 1,761
colonoscopy procedures during the study period (for indications as stated above). The overall ADR was 26.9%, 30.3% in
men and 23.5% in women. Factors contributing to statistically higher adenoma detection were successful caecal intubation
and procedure performed by the gastroenterology team. However positive FOBT and good quality of bowel preparation did
not show statistical difference in terms of adenoma detection rate (table 2).
CONCLUSION: Overall ADR in our centre was comparable to the international recommended benchmark. Discrepancy shown
in the adenoma detection rate between gastroenterology team and non-gastroenterology team mainly highlight different in
training experience and approach of doing endoscopy. Combine endoscopy training involving both gastroenterology and
surgeon maybe require to overcome this gap.
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