The Miss Rate for Colorectal Adenoma Determined by Quality-Adjusted, Back-to-Back Colonoscopies.
- Author:
Sang Bong AHN
1
;
Dong Soo HAN
;
Joong Ho BAE
;
Tae Jun BYUN
;
Jong Pyo KIM
;
Chang Soo EUN
Author Information
1. Department of Internal Medicine, Hanyang University College of Medicine, Guri, Korea. hands@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
Colonoscopy;
Adenoma;
Miss rate;
Quality
- MeSH:
Adenoma;
Adenomatous Polyps;
Colon;
Colonoscopy;
Humans;
Polyps;
Prospective Studies
- From:Gut and Liver
2012;6(1):64-70
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Colonoscopy is considered to be the gold standard for detecting adenomatous polyps. Polyps are missed during colonoscopic examination at a rate that varies from 6% to 27%. The adenoma miss rate affects colonoscopic surveillance intervals and procedural quality. We aimed to assess the adenoma miss rate and the variables affecting the rate using same-day, quality-adjusted, back-to-back colonoscopies. METHODS: This prospective study was performed at a single institution and included 149 patients. Two consecutive same-day colonoscopies were performed by two experienced endoscopists. The adenoma miss rates and variables affecting the missed adenomas, including polyp characteristics and procedure times, were evaluated. RESULTS: The miss rates of polyps, adenomas, and advanced adenomas were 16.8%, 17%, and 5.4%, respectively. The smaller polyps and increased number of polyps detected during the first colonoscopy were more likely to be missed. A longer insertion time during the colonoscopy was correlated with an increased adenoma detection rate. CONCLUSIONS: There was a significant miss rate in the detection of colonic adenomas even in quality-adjusted, back-to-back colonoscopies. The adenoma miss rate can be reduced with a sufficient observation time during colonoscopic insertion. The development of specific technological methods to reduce the adenoma miss rate is necessary.
