Correlation between adenoma detection rate in colonoscopy- and fecal immunochemical testing-based colorectal cancer screening programs. Issue 2 (March 2017)

• Record Type: Journal Article
• Authors: Cubiella, Joaquín; Castells, Antoni; Andreu, Montserrat; Bujanda, Luis; Carballo, Fernando; Jover, Rodrigo; Lanas, Ángel; Morillas, Juan Diego; Salas, Dolores; Quintero, Enrique
• Is Part Of: United European Gastroenterology journal. Volume 5:Issue 2(2017)
• Page Start: 255
• Page End: 260
• Publication Date: 2017-03
• Subjects: Colorectal adenoma -- colorectal neoplasm -- fecal immunochemical test -- colonoscopy -- colorectal cancer screening -- adenoma detection rate; Gastroenterology -- Periodicals; Periodicals; 616.33005
• DOI: 10.1177/2050640616660662
• Languages: English
• ISSNs: 2050-6406

Abstract

Background: The adenoma detection rate (ADR) is the main quality indicator of colonoscopy. The ADR recommended in fecal immunochemical testing (FIT)-based colorectal cancer screening programs is unknown. Methods: Using the COLONPREV (NCT00906997) study dataset, we performed a post-hoc analysis to determine if there was a correlation between the ADR in primary and work-up colonoscopy, and the equivalent figure to the minimal 20% ADR recommended. Colonoscopy was performed in 5722 individuals: 5059 as primary strategy and 663 after a positive FIT result (OC-Sensor™; cut-off level 15 µg/g of feces). We developed a predictive model based on a multivariable lineal regression analysis including confounding variables. Results: The median ADR was 31% (range, 14%–51%) in the colonoscopy group and 55% (range, 21%–83%) in the FIT group. There was a positive correlation in the ADR between primary and work-up colonoscopy (Pearson's coefficient 0.716; p < 0.001). ADR in the FIT group was independently related to ADR in the colonoscopy group: regression coefficient for colonoscopy ADR, 0.71 ( p = 0.009); sex, 0.09 ( p = 0.09); age, 0.3 ( p = 0.5); and region 0.00 ( p = 0.9). The equivalent figure to the 20% ADR was 45% (95% confidence interval, 35%–56%). Conclusions: ADR in primary and work-up colonoscopy of a FIT-positive result are positively and significantly correlated.