P2367 - Same Endoscopist, Different Center: Does Site Matter?

Anthony Choi, MD¹, Rachel Engelberg, MD¹, Anna Krigel, MD, MS², Benjamin Lebwohl, MD², Felice Schnoll-Sussman, MD¹, David Wan, MD^3
1New York-Presbyterian/Weill Cornell Medical Center, New York, NY; ²Columbia University Medical Center, New York, NY; ³New York Presbyterian Weill Cornell Medicine, New York, NY

Introduction: Detecting precancerous lesions has been associated with a reduction of colorectal cancer (CRC) incidence and mortality. Sessile serrated lesions (SSL) may account for about a third of CRCs, making SSL detection rate (SSLDR) an important clinical benchmark. There is a wide variability of SSLDR reported in the literature, from 0 to 13%. There have been various studies looking at factors that may improve SSLDR, including patient factors, endoscopist factors, and technological factors. Our tertiary care, academic institution comprises of two endoscopy centers, one of which recently opened in 2018 and is distinct in several ways including equipment and room design. We aimed to determine if the same endoscopists would have different adenoma detection rates (ADR) and SSLDRs at the two different sites.

Methods: From 5/1/17 to 9/30/19, data was collected for all consecutive screening colonoscopies performed by endoscopists who performed more than 20 per year. Only screening colonoscopies of average risk patients with good preps were included. Endoscopy center A was the older center, and B was the newer center located one street block away. Both centers accommodated outpatient screening colonoscopies, employed similarly trained staff including pathologists, and stocked the same high definition colonoscopes with narrow band imaging capabilities and mucosal exposure devices. However, a notable difference is the endoscopy monitor, where center A uses a 26’’, 1920 x 1200 pixel screen compared to 32’’, 3840 x 2160 pixel panel at center B. We used paired t tests to evaluate for differences in ADR and SSLDR across sites.

Results: Fifteen endoscopists performed 3094 cases eligible for ADR and SSLDR calculations during this time, 555 in center A and 2539 in B. The overall average SSLDR was 3.4% in center A and 8.4% in center B. The mean difference (SD) by endoscopist was 3.9% (0.02), with a p value of 0.01. In contrast, there was no statistically significant difference in ADR with a mean difference (SD) of 1.17% (0.0567), p=0.64.

Discussion: Among a group of endoscopists who performed colonoscopy at 2 sites, there was a higher SSLDR at the newly opened ambulatory center. This may be due to the factors associated with a state-of-the-art center including larger and better resolution endoscopy monitors and bigger room space, and warrants further study.


Disclosures:


Anthony Choi, MD¹, Rachel Engelberg, MD¹, Anna Krigel, MD, MS², Benjamin Lebwohl, MD², Felice Schnoll-Sussman, MD¹, David Wan, MD³. P2367 - Same Endoscopist, Different Center: Does Site Matter?, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.