Polyp-Finding Skill Is Key to Colonoscopy Success
Study Shows Importance of a Doctor's High Polyp-Detection Rate
Assessing Colonoscopy Quality continued...
Forty-two such cancers were identified among about 45,000 patients screened, but only one of these occurred in a patient whose exam was performed by a doctor with an adenoma detection rate above 20%, Regula says.
"The risk was significantly higher among patients whose colonoscopies were performed by [doctors] with detection rates of less than 20%," he says.
Regula says doctors who perform colonoscopies should keep track of their adenoma detection rate and provide this information to patients.
American Cancer Society (ACS) Director of Prostate and Colorectal Cancers Durado Brooks, MD, agrees, but adds that this probably isn't happening much in clinical settings.
"Certainly if patients start asking for this kind of data, it may start happening more," he tells WebMD.
While the Polish study failed to show the value of making it to the beginning of the colon as a measure of exam quality, Brooks says other studies suggest a benefit.
Studies have also shown that the more time a doctor takes to examine the colon as the tube is withdrawn, the better.
It is recommended that doctors take at least six minutes for the withdrawal phase of a colonoscopy. A recent assessment of this practice found that those who did this identified significantly more polyps than those who took less time.
"It is now clear that polyps missed on the way in can be detected with careful examination on the way out," he says.
Brooks says people who have had colonoscopies can have confidence in the findings, even if they don't know their doctor's adenoma detection rate or withdrawal time.
"I would hate for people to think their colonoscopy was worthless," he says. "This is a very effective tool for identifying and preventing cancer."