Adenoma-based Colonoscopy Quality Metrics for the 45-49 Years Old Military Screening Population

Geoffrey A. Bader*, Carl L. Kay, Zachary Eagle, Brandon W. Kuiper, Charles B. Miller, John G. Gancayco

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND AND AIMS: With the rising incidence of colorectal cancer in younger individuals, guidelines now recommend initiating average-risk screening at age 45 years. We sought to assess the impact of this younger screening population on established and emerging colonoscopy quality metrics. METHODS: We compared all well-described lesion detection rates by colonic segment removed during initial, average-risk screening colonoscopies in the San Antonio Market military healthcare network from July 2019 to September 2022. RESULTS: A total of 2165 colonoscopies met the inclusion criteria, with 755 (34.9%) colonoscopies performed on patients aged 45-49 years old. The detection rates for adenomas, proximal adenomas, advanced adenomas, and adenomas per colonoscopy were lower in the 45-49 years old group (33.4%, 18.7%, 3.8%, and 0.58, respectively) compared with the 50-75 years old group (42.7%, 24.2%, 7.7%, and 1.11, respectively; all P < 0.05). There was no difference in serrated polyp detection in the 45-49 years old group (11.5%) compared with the 50-75 years old group (12.5%; P = 0.287). There were no differences in withdrawal times, cecal intubation rates, or bowel preparation adequacy across age groups. CONCLUSION: In our screening population, we found that adenoma-based colonoscopy quality metrics were significantly lower in the 45-49 years old population compared to the traditional screening age cohort, while there was no difference in serrated polyp detection. Endoscopists should anticipate a small decline in colonoscopy quality benchmarks as the screening population becomes younger, although these results require validation through multicenter, prospective monitoring.

Original languageEnglish
JournalTechniques and Innovations in Gastrointestinal Endoscopy
DOIs
StateAccepted/In press - 2024
Externally publishedYes

Keywords

  • Adenoma detection rate
  • Adenoma per colonoscopy
  • Colonoscopy quality
  • Screening colonoscopy
  • Serrated polyp detection rate

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