Quality in Colonoscopy
Questions you should ask when choosing a physician to perform your screening colonoscopy:
1. What is the Adenoma Detection Rate (ADR)?
This is the number one indicator of quality for screening colonoscopy. ADR is the percentage of patients undergoing screening colonoscopy who are found to have precancerous polyps. The higher a physician's ADR the better, meaning, they are finding more precancerous polyps. A recent study by New England Journal of Medicine showed that patients who had colonoscopy by physicians with a higher ADR were less likely to develop colon cancer years later. National guidelines recommend a physician have an ADR of at least 25% (20% for female patients, 30% for male patients. Males have more polyps than females).
*Our physicians as a group have an average ADR of 46.3 percent (range 35.4 - 59.5).
2. What is their colonoscopy withdraw time?
How long do they take to look for polyps as they are withdrawing the scope? No surprise here, in general, the longer the withdraw time, the higher the ADR. National guidelines recommend a withdraw time of at least six minutes.
*Our physicians have an average withdraw time of 11 minutes (range 8.5 - 13.3).
3. What is their Cecal Intubation Rate?
This is the percentage of time that a physician reaches the cecum during colonoscopy. Did they get all the way around the colon during the exam? National guidelines recommend a Cecal Intubation Rate of at least 9 percent.
*Our physicians have an average Cecal Intubation Rate of 99 percent (range 98.2 - 99.6).
*The above data was calculated using electronic medical records from 5806 patients who had screening colonoscopy performed by 6 physicians from Gastroenterology in Cedar Rapids, Iowa, from 01-01-13 to 12-31-14.