Kim TJ, et al. - In this work, researchers aimed at determining the association between the adenoma detection rate (ADR) and the risk for metachronous advanced colorectal neoplasia (AN) in patients with low-risk adenomas. Findings suggested an inverse association of the ADR of the endoscopist with the risk of metachronous AN in these patients.

Methods

• 7,171 participants with no or 1-2 non-advanced adenomas at first-time screening colonoscopy were identified.
• An investigation of the risk of metachronous AN was performed at surveillance colonoscopy, according to clinical characteristics and the ADR.

Results

• Multivariate analysis suggested that the risk for metachronous AN had strong association with increasing age, male sex, increasing number of adenoma and the ADR of the endoscopist.
• With the ADR modeled as a continuous variable, each 1.0% increase in the rate of ADR predicted a 3.0% decrease in the risk of metachronous AN (adjusted odds ratio [aOR], 0.97; 95% confidence CI [CI], 0.95-0.99).
• Using a binary cut-off (32%) for modeling ADR indicated that the risk of metachronous AN was reduced in patients of endoscopists with an ADR ≥32% (aOR, 0.53; 95% CI, 0.35-0.83).
• In addition, a reduction in the risk of metachronous AN was evident (aOR, 0.66; 95% CI, 0.46-0.95) in patients of endoscopist with an ADR in the highest tertile, compared to patients of endoscopists with ADR in the lowest tertile.
• For patients with low-risk adenomas in comparison to patients with no adenoma, significant impact of ADR on metachronous AN was observed.