A recent article in the Journal of the American Medical Association (JAMA) evaluated colonoscopy screening programs. A key quality indicator for colonoscopies is the “adenoma detection rate” (ADR). Colon cancer most commonly develops from a type of polyp called an adenoma. Adenomas are found and removed during colonoscopy. In 2014 The New England Journal of Medicine (NEJM) published a study showing a significant reduction in the likelihood of developing colon cancer among patients whose doctors removed a greater number of adenomas. Gastroenterologists who perform colonoscopies have different adenoma “pick-up” rates. In fact, in the NEJM study, the doctors’ adenoma detection rates ranged between 7.4 and 52.5%.

The most recent study by JAMA looked at the lifetime benefits, complications, and costs of colonoscopy screening programs at various levels of ADR. The study looked at data from 57,588 patients who were seen by 136 physicians between 1998 and 2010. The study found that the lifetime incidence of colon cancer, and the likelihood of death from colon cancer decreased as the ADR rates increased. Higher ADR rates were also found to be linked to lower screening costs. The authors attributed this to the avoidance of expensive cancer treatment costs. The study concluded that higher ADR in screening colonoscopy is associated with a lower risk of colon cancer, a lower death rate from colon cancer, and significant cost savings.

Dr. Schub takes great pride in his high adenoma pick-up rate. Make sure you ask your gastroenterologist for his or her adenoma detection rate before scheduling this important procedure!

For more information:

Douglas Corley, Christopher Jensen, Amy Marks, et al., “Adenoma Detection Rate and Risk of Colorectal Cancer and Death,” New England Journal of Medicine. 370:1298-1306, April 3, 2014. DOI: 10.1056/NEJMoa1309086

Reinier G. S. Meester, Chyke A Doubeni, Iris Lansdorp-Vogelaar, et al., “Variation in Adenoma Detection Rate and the Lifetime Benefits and Cost of Colorectal Cancer Screening. A Microsimulation Model,” JAMA. 2015; 313 (23).