Again, No Need To Adjust Adenoma Detection Rate After Inclusion of 45- To 49-Year-Olds
Douglas K. Rex, MD, MASGE, reviewing Ladabaum U, et al. Clin Gastroenterol Hepatol 2022 May 14.
This study looked at a large health care system’s first-time screening colonoscopies from the period October 2017 through December 2018, prior to the American Cancer Society inclusion of 45- to 49-year-olds in its screening recommendation, compared with screening colonoscopies performed from January 2019 through August 2021, after the release of the new recommendation.
The proportion of first-time screening colonoscopies performed in 45- to 49-year-olds increased from 3.5% in the first period to 11.6% in the second period. The overall adenoma detection rate (ADR) among 45- to 79-year-old patients increased from 35.1% to 42.6%, and the ADR in 45- to 49-year-old patients increased from 22% to 34.3%, suggesting the impact of a quality program that was only recently fully instituted. During the second period, the ADR, advanced-ADR, sessile serrated lesion (SSL) detection rate, advanced-SSL detection rate, and adenomas per colonoscopy in the 45- to 49-year-olds were similar (34.3%, 6.3%, 8.6%, 2.9%, and 0.58, respectively) to those in 50- to 54-year-olds (38.2%, 5.8%, 9.4%, 3.0%, and 0.63) and also very similar to those in 60- to 64-year-olds who underwent rescreening colonoscopy (33.4%, 6.1%, 7.2%, 2.3%, and 0.61).
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
Ladabaum U, Shepard J, Mannalithara A. Adenoma and sessile serrated lesion detection rates at screening colonoscopy for ages 45-49 years vs. older ages since the introduction of new colorectal cancer screening guidelines. Clin Gastroenterol Hepatol 2022 May 14. (Epub ahead of print) (https://doi.org/10.1016/j.cgh.2022.04.037)