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Gastrointest Endosc. 2017 Mar;85(3):581-587. doi: 10.1016/j.gie.2016.08.029. Epub 2016 Sep 3.

Maintaining low non-neoplastic polypectomy rates in high-quality screening colonoscopy.

Author information

1
Department of Medicine, Division of Digestive Diseases, Rush University Medical Center, Chicago, Illinois, USA.
2
Department of Pathology, Rush University Medical Center, Chicago, Illinois, USA.

Abstract

BACKGROUND AND AIMS:

Non-neoplastic polypectomies (NNPs) add pathology and procedural costs but do not reduce cancer risk and should be minimized. We sought to define the minimal non-neoplastic polypectomy rate (NNPR) for those colonoscopists achieving high-quality colorectal cancer screening based on adenoma detection rates (ADRs).

METHODS:

NNPRs for colonoscopists achieving high-quality adenoma detection rates were reported to determine minimal NNPR goals. Two approaches to tracking NNPR monitoring were compared: (1) total NNPR, an NNPR inclusive of all non-neoplastic specimens with exclusion of only hyperplastic polyp, sessile serrated polyp, and adenoma; and (2) normal tissue-only NNPR, an NNPR inclusive of those specimens with only normal colonic mucosa or lymphoid follicles.

RESULTS:

For those performing colonoscopy with high-quality ADRs (≥25%), half (6/12) of the colonoscopists had a total NNPR of ≤8.5% and 2 gastroenterologists had a total NNPR of ≤3.4%. The mean total NNPR of the cohort was 8.7% versus the normal tissue only NNPR, which was 7.5% (mean difference of 1.2%, standard deviation ± 0.97). The widest variation between total NNPR versus normal tissue only NNPR for any colonoscopist was 2.9%. The total NNPR ranged between 2.6% and 21.3% among 14 colonoscopists.

CONCLUSIONS:

Colonoscopy with a high-quality ADR can be achieved while maintaining a low total NNPR. A total NNPR, inclusive of all non-neoplastic specimens as an alternative to an approach in which all specimens require individual review in order to select out only normal tissue can be considered for monitoring of NNPR.

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PMID:
27597424
DOI:
10.1016/j.gie.2016.08.029
[Indexed for MEDLINE]

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