E0171 - Comparison of the Effect of a Positive Stool DNA Test on Mucosal Inspection Time to Average Risk Screening Colonoscopy

Malini Chauhan, MD, Brendan Andres, MD, Elise M. Le Cam, MD, MS, Amar Vedamurthy, MD, MSCI, MRCP, Avin Aggarwal, MD
University of Arizona, Tucson, AZ

Introduction: Studies have shown that longer withdrawal times correlated with increased rates of adenoma detection (ADR). Quality metrics are often focused on patients with polyps. Withdrawal time for procedures in which no polyps were detected represents the mucosal inspection time and can be a marker for high-quality colonoscopy. We aimed to evaluate mucosal inspection time in patients with positive MT-sDNA testing in comparison to average-risk screening colonoscopy in a tertiary care center.

Methods: We performed a retrospective chart review of patients who underwent colonoscopy for indication of positive MT-sDNA stool test-based screening or screening based on average risk performed at a tertiary care center. We included patients without identification of polyp during colonoscopy and a completed study. Patients with poor preparation were excluded. Data collection included demographics, bowel preparation quality, time of day, day of the week, ASA grade, cecal intubation time, withdrawal time, complexity, and fellow involvement. Multivariable models were built to assess the relationship between withdrawal time and the indication for which the colonoscopy was performed

Results: A total of 225 colonoscopies were identified wherein no polyps were removed, of which 58 were performed for positive stool MT-sDNA (Stool DNA+ group) and 167 for screening for average-risk (screening group). Patients in the “Stool DNA+ group” were older (66 vs. 59; p< 0.04), had a longer cecal intubation time (7 vs. 5 minutes; p< 0.04) and had tortuous colon. The "Stool DNA+ group" had a longer withdrawal time than those in the screening group (11 vs. 9, P< 0.04). In a multivariable analysis, after adjusting for age, ASA grade, procedure time (AM or PM), and time to the cecum, the withdrawal time in “Stool DNA+ group” was 2.6 ( 95% CI 1.5 – 3.7, p< 0.04) minutes longer than screening for average-risk individuals. After a median follow-up of 2.7 person-years, no post-colonoscopy cancers were reported.

Discussion: In our pilot study, the withdrawal time or mucosal inspection time was higher in patients with positive stool MT-sDNA testing compared to average-risk screening colonoscopy. This may serve as a benchmark for high-quality colonoscopy and should be translated into a quality metric for all screening colonoscopies irrespective of risk.




Disclosures:


Malini Chauhan, MD, Brendan Andres, MD, Elise M. Le Cam, MD, MS, Amar Vedamurthy, MD, MSCI, MRCP, Avin Aggarwal, MD. E0171 - Comparison of the Effect of a Positive Stool DNA Test on Mucosal Inspection Time to Average Risk Screening Colonoscopy, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.