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The adenoma detection rate is the share of screening colonoscopies in which an endoscopist finds at least one adenoma. It is the best single measure of how good a colonoscopy service is, because the patients of endoscopists who find more polyps go on to get fewer cancers and to die of them less often.
The measure. The adenoma detection rate is the proportion of a given endoscopist's screening colonoscopies in which one or more adenomas are found. It is a proxy for how carefully the bowel is inspected: withdrawal time, bowel preparation, technique behind folds, and willingness to remove small flat lesions all feed into it.
What it predicts. Across 314,872 colonoscopies by 136 gastroenterologists in one American health system, detection rates ranged from 7.4 to 52.5 percent. Comparing the highest to the lowest fifth, the adjusted hazard ratio was 0.52 for any interval colorectal cancer, 0.43 for advanced-stage interval cancer and 0.38 for fatal interval cancer, and every 1.0 percentage point of detection rate was worth a 3.0 percent lower risk of cancer (Corley 2014). In a Polish screening programme of 45,026 people examined by 186 endoscopists, the detection rate was the quality indicator that predicted interval cancer, and caecal intubation rate was not; endoscopists below 20 percent had roughly a tenfold higher hazard than those at or above it (Kaminski 2010).
Why it matters to a reader. A colonoscopy is not a single standardised thing, and the difference between a careful and a hurried one is measurable in cancers years later. National programmes publish detection rates and use them to set thresholds for accreditation; the serrated equivalent, the sessile serrated polyp detection rate, is newer and less standardised because those lesions are the harder ones to see.
Showing the technology this term belongs to: Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood).
Shares Polyp types in the bowel, Surveillance intervals after polypectomy, Serrated pathway, Colonoscopy and the tags gi, colorectal.
Shares Interval cancer, Surveillance intervals after polypectomy, Colonoscopy, Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood) and the tags gi, colorectal.
Shares Interval cancer, Colonoscopy, Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood), Colon cancer (adenocarcinoma of the colon) and the tags gi, colorectal.
Shares Interval cancer, Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood), Colon cancer (adenocarcinoma of the colon), Rectal cancer and the tags gi, colorectal.
Shares Serrated pathway, Colon cancer (adenocarcinoma of the colon), Colorectal cancer and the tags gi, colorectal.
Shares Colon cancer (adenocarcinoma of the colon), Rectal cancer, Colorectal cancer and the tags gi, colorectal.
Shares Colonoscopy, Colorectal cancer and the tags gi, colorectal.
Shares Colon cancer (adenocarcinoma of the colon), Rectal cancer, Colorectal cancer and the tags gi, colorectal.