Adenoma detection rate is one of the key colonoscopy quality indicators. A recent study published in JAMA examined the lifetime benefits, complications and costs of colonoscopy screening programs at various levels of ADR.
Here are seven things to know about the study.
1. The study pulled data from 57,588 patients examined by 136 physicians between the years 1998 and 2010 and used microsimulation modeling.
2. In simulation modeling, the lifetime risk of colorectal cancer in unscreened patients was 34.2 per 1,000, and risk of mortality was 13.4 per 1,000.
3. The study divided ADRs into quintiles:
• Quintile 1: 21.3 percent
• Quintile 2: 25.6 percent
• Quintile 3: 30.9 percent
• Quintile 4: 38.7 percent
• Quintile 5: 38.7 percent
4. Amongst screened patients, lifetime incidence and mortality decreased with lower to higher ADRs.
5. Lifetime incidence for every five percentage point increase of ADR was on average 11.4 percent lower and 12.8 percent lower for mortality.
6. Estimated net screening costs were $2.1 million in quintile 1, but $1.8 million in quintile 5, which can be attributed to averted cancer treatment costs.
7. The study authors concluded higher ADR in screening colonoscopy was associated with lower risk of colorectal cancer incidence and mortality, as well as lower overall costs.