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Adenoma Detection Rate in Colonoscopy

Is Indication a Predictor?

Yang, Phillip F. MBBS, MS; Wong, Shing W. MBBS, MS, FRACS

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: April 2016 - Volume 26 - Issue 2 - p 156–161
doi: 10.1097/SLE.0000000000000253
Original Articles

Purpose: To describe factors that may influence adenoma detection rate (ADR), with an emphasis on the indication for colonoscopy.

Methods: Consecutive colonoscopies performed by a single endoscopist between January 2008 and December 2014 were reviewed. Indications for colonoscopy were tested for association with ADR after adjusting for age and sex.

Results: A total of 2648 colonoscopies were analyzed. Adenomas were detected in 630 patients (23.8%). Overall ADR was 22.9% in patients undergoing screening colonoscopy. ADR was higher in fecal occult blood test–triggered screening colonoscopies (32%) than colonoscopies performed for patients with a family history of colorectal cancer (21.7%) or asymptomatic average-risk individuals (20.4%) (P=0.05). ADR was 36.1% in patients undergoing surveillance colonoscopy and ranged from 12% to 30% in patients with gastrointestinal symptoms undergoing diagnostic colonoscopy.

Conclusions: ADR differs depending on whether the indication is screening, surveillance, or diagnosis. Within screening colonoscopies, ADR seems to be higher in patients with a positive fecal occult blood test.

*Department of Surgery, Prince of Wales Hospital

Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales

Department of Surgery, Prince of Wales Private Hospital, NSW, Australia

The authors declare no conflicts of interest.

Reprints: Phillip F. Yang, MBBS, MS, Department of Surgery, Prince of Wales Hospital, Barker St., Randwick, NSW 2031, Australia (e-mail:

Received August 4, 2015

Accepted December 21, 2015

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