Adenoma Detection Rate in Colonoscopy: Is Indication a Predictor?

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Purpose:To describe factors that may influence adenoma detection rate (ADR), with an emphasis on the indication for colonoscopy.Methods:Consecutive colonoscopies performed by a single endoscopist between January 2008 and December 2014 were reviewed. Indications for colonoscopy were tested for association with ADR after adjusting for age and sex.Results:A total of 2648 colonoscopies were analyzed. Adenomas were detected in 630 patients (23.8%). Overall ADR was 22.9% in patients undergoing screening colonoscopy. ADR was higher in fecal occult blood test–triggered screening colonoscopies (32%) than colonoscopies performed for patients with a family history of colorectal cancer (21.7%) or asymptomatic average-risk individuals (20.4%) (P=0.05). ADR was 36.1% in patients undergoing surveillance colonoscopy and ranged from 12% to 30% in patients with gastrointestinal symptoms undergoing diagnostic colonoscopy.Conclusions:ADR differs depending on whether the indication is screening, surveillance, or diagnosis. Within screening colonoscopies, ADR seems to be higher in patients with a positive fecal occult blood test.

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