TY - JOUR
T1 - Prevalence of missed adenomas in patients with inadequate bowel preparation on screening colonoscopy
AU - Chokshi, Reena V.
AU - Hovis, Christine E.
AU - Hollander, Thomas
AU - Early, Dayna S.
AU - Wang, Jean S.
PY - 2012/6
Y1 - 2012/6
N2 - Background: The prevalence of missed polyps in patients with inadequate bowel preparation on screening colonoscopy is unknown. Objective: To determine the prevalence of missed adenomas in average-risk patients presenting for screening colonoscopy who are found to have inadequate bowel preparation. Design: Retrospective chart review. Endoscopy and pathology reports were examined to determine the characteristics of polyps. Data from repeat colonoscopies were collected through 2010. Setting: Outpatient endoscopy center at an academic medical center. Patients: This study involved patients who underwent outpatient average-risk screening colonoscopy between 2004 and 2009 documented to have inadequate bowel preparation and who had colonoscopy to the cecum. Main Outcome Measurements: Initial adenoma detection rate and adenoma detection rate on follow-up examination. Results: Inadequate bowel preparation was reported on 373 patients, with an initial adenoma detection rate of 25.7%. Of 133 patients who underwent repeat colonoscopy, 33.8% had at least 1 adenoma detected, and 18.0% had high-risk states detected (<3 adenomas, 1 adenoma <1 cm, or any adenoma with villous features or high-grade dysplasia). Per-adenoma miss rate was 47.9%. Among patients with at least 1 adenoma on repeat colonoscopy, 31.1% had no polyps on initial colonoscopy; mean time between colonoscopies was 340 days. Among patients with high-risk states, 25.0% had no polyps seen on initial colonoscopy; mean time between colonoscopies was 271 days. Limitations: Retrospective design. Conclusion: Adenomas and high-risk lesions were frequently detected on repeat colonoscopy in patients with inadequate bowel preparation on initial screening colonoscopy, suggesting that these lesions were likely missed on initial colonoscopy.
AB - Background: The prevalence of missed polyps in patients with inadequate bowel preparation on screening colonoscopy is unknown. Objective: To determine the prevalence of missed adenomas in average-risk patients presenting for screening colonoscopy who are found to have inadequate bowel preparation. Design: Retrospective chart review. Endoscopy and pathology reports were examined to determine the characteristics of polyps. Data from repeat colonoscopies were collected through 2010. Setting: Outpatient endoscopy center at an academic medical center. Patients: This study involved patients who underwent outpatient average-risk screening colonoscopy between 2004 and 2009 documented to have inadequate bowel preparation and who had colonoscopy to the cecum. Main Outcome Measurements: Initial adenoma detection rate and adenoma detection rate on follow-up examination. Results: Inadequate bowel preparation was reported on 373 patients, with an initial adenoma detection rate of 25.7%. Of 133 patients who underwent repeat colonoscopy, 33.8% had at least 1 adenoma detected, and 18.0% had high-risk states detected (<3 adenomas, 1 adenoma <1 cm, or any adenoma with villous features or high-grade dysplasia). Per-adenoma miss rate was 47.9%. Among patients with at least 1 adenoma on repeat colonoscopy, 31.1% had no polyps on initial colonoscopy; mean time between colonoscopies was 340 days. Among patients with high-risk states, 25.0% had no polyps seen on initial colonoscopy; mean time between colonoscopies was 271 days. Limitations: Retrospective design. Conclusion: Adenomas and high-risk lesions were frequently detected on repeat colonoscopy in patients with inadequate bowel preparation on initial screening colonoscopy, suggesting that these lesions were likely missed on initial colonoscopy.
UR - http://www.scopus.com/inward/record.url?scp=84862776707&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2012.01.005
DO - 10.1016/j.gie.2012.01.005
M3 - Article
C2 - 22381531
AN - SCOPUS:84862776707
VL - 75
SP - 1197
EP - 1203
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
SN - 0016-5107
IS - 6
ER -