Longer Colonoscopy Time Ups Detection
Doctors Who Take More Time Find More Abnormal Growths, Study Shows
Dec. 13, 2006 -- Getting a colonoscopy? You may want to find a doctor who
takes his time with the procedure, a new study shows.
Doctors who took longer to evaluate a patient's colon were almost four times
as likely to spot one particular type of growth, according to the study.
In a colonoscopy, the doctor guides a thin, flexible tube with a tiny camera
through the colon.
The colonoscopy camera lets the doctor check the colon for abnormalities,
including cancerous and precancerous growths.
The new study, published in The New England Journal of Medicine,
found that colonoscopies that took longer flagged more abnormal growths than
The findings come from Robert Barclay, MD, and colleagues at the University
of Illinois College of Medicine in Rockford, Ill.
Barclay's team analyzed more than 7,800 colonoscopies done by 12
gastroenterologists from January 2003 through March 2004.
The gastroenterologists worked at the same Rockford gastroenterology
practice as Barclay and most of the researchers.
The doctors were board certified and experienced, having done more than
3,000 colonoscopies before the study.
The patients involved were generally at "average risk" for colon cancer, write the researchers.
On average, it took seven minutes for a doctor to guide the colonoscopy
device to the top of the colon during the procedure, and another six minutes to
withdraw it as he evaluated the inside of the colon.
If the doctor stopped to remove an abnormal growth, withdrawal took four
extra minutes, on average.
The study's key finding: Slower withdrawal of the device appears to result
in a more thorough colonoscopy.
Doctors who spent more than six minutes withdrawing the colonoscopy tube
found more abnormal growths than those who withdrew it in less than six
minutes, according to the study.
For instance, the detection rate for one particular type of growth, called
an adenoma, was "nearly four times as great" among doctors who took
more time withdrawing the tube.
How long should a doctor spend withdrawing the tube? The study doesn't
settle that question.
While other experts have suggested six to 10 minutes, Barclay's team doesn't
make a specific time recommendation.
"Longer procedure time does not necessarily mean higher quality,"
David Lieberman, MD, says in a Journal editorial. "However, the results of
this study are intuitive."
Lieberman works in Portland, Ore., at the gastroenterology department of
Oregon Health and Science University and the Portland Veterans Affairs Medical
Careful colon examination should boost the adenoma detection rate,
"which is an important indicator of quality," says Lieberman.