Penn State University Milton S. Hershey Medical Center and College of Medicine Hershey, PA, United States
Myunghoon Kim, MD, Hadie Razjouyan, MD, MPH (Epi) Penn State University Milton S. Hershey Medical Center and College of Medicine, Hershey, PA
Introduction: As we continue to improve patient awareness of screening colonoscopy and perform colonoscopy in a larger percentage of the population, the quality of screening colonoscopy becomes a major area of concern to increase our yield in finding and acting on pre-cancerous polyps. One of the quality indicators is adenoma detection rate (ADR). Current literature lacks consistent message on the correlation between the number of years being out of training to ADR.
Methods: We conducted a retrospective study of screening colonoscopies performed at an academic ambulatory surgical center. We categorized the gastroenterologists based on their clinical subspecialty focus, which includes general/motility, hepatology, inflammatory bowel disease (IBD), and interventional endoscopy. We looked at variables pertaining to the patients’ and providers’ backgrounds and the procedural reports. Each procedure year was subtracted from the graduation year of the gastroenterologist defining a new variable called out of training. We assessed the ADR over time based on number of years being out of training.
Results: A total of 5,271 (male: 49.1%) complete first-time screening colonoscopies were performed from 2010 to 2020 by 16 gastroenterologists (male: 62.5%, general/motility specialists: 3, hepatologists: 3, IBD specialists: 4, interventional endoscopists: 6). 87.6% had either adequate, good, or excellent bowel preparation. The ADR between each specialty focus were 27.5% (n=264) for general/motility, 31.4% (n=409) for hepatology, 38.4% (n=346) for IBD, and 37.5% (n=765) for interventional endoscopy. The average (range) years of being out of training was as follows; general/motility: 19 (1-40), hepatology: 13 (6-24); IBD: 5 (1-10), interventional endoscopy: 13 (1-36). Inflammatory bowel disease subspecialist had steeper improvement in ADR as compared to Hepatologists, interventional endoscopist, and general/motility gastroenterologist, Figure 1.
Discussion: As gastroenterologists get out of training, the ADR improves. The improvement slope is steeper for inflammatory bowel disease subspecialists. The result of this study requires further validations with a larger number of gastroenterologists.
Figure: Figure 1. Adenoma detection rate over time being of out of training
Myunghoon Kim indicated no relevant financial relationships.
Hadie Razjouyan indicated no relevant financial relationships.
Myunghoon Kim, MD, Hadie Razjouyan, MD, MPH (Epi). P0249 - Does the Number of Years Being out of Gastroenterology Training Affect the Adenoma Detection Rate?, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.