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Background <p> Endoscopists’ adenoma detection rate (ADR) may change over time and dynamic ADR has been identified as a predictor for post-screening colorectal cancer. However, whether low-risk findings removed by an endoscopist with a lower dynamic ADR benefit from a shorter duration of follow-up requires further research.</p> Methods <p>We conducted a two-center retrospective study of individuals who had low-risk findings removed and underwent subsequent surveillance colonoscopy. Endoscopists’ dynamic ADR was the ADR of the previous 100 screening colonoscopies performed by the same endoscopist. A Cox-regression model and Kaplan–Meier survival analysis were used to explore the relationship between dynamic ADR and metachronous advanced colorectal neoplasia (ACRN).</p> Results <p>Totally, 3471 individuals who had low-risk findings removed in baseline colonoscopy were included in analysis. Decreasing endoscopists’ dynamic ADR was independently associated with metachronous ACRN. A 3.97-, 2.21-, and 2.67-fold increased risk for metachronous ACRN was observed in individuals of which baseline colonoscopy was performed by an endoscopist with a dynamic ADR of &lt; 15%, 15–19%, and 20–24%, respectively, compared with those with the highest dynamic ADR (≥ 25%). The cumulative incidence of metachronous ACRN reached the 5% threshold at 4.5&#xa0;years, 7.3&#xa0;years, and 6.2&#xa0;years in the dynamic ADR &lt; 15%, 15–19%, and 20–24% group, respectively.</p> Conclusion <p>Endoscopists’ dynamic ADR influences the risk of metachronous ACRN after removal of low-risk findings in screening colonoscopy. Individuals undergoing removal of low-risk findings in screening colonoscopy by an endoscopist with a dynamic ADR &lt; 25% may benefit from a shorter duration of follow-up interval.</p>

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Dynamic adenoma detection rate influences the risk of metachronous advanced neoplasia after removal of low-risk findings in screening colonoscopy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月17日

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  • Zhiyu Dong,
  • Ouyang Li,
  • Yanglei Li,
  • Zili Xiao,
  • Feng Li,
  • Shuchang Xu,
  • Danian Ji

摘要

Background

Endoscopists’ adenoma detection rate (ADR) may change over time and dynamic ADR has been identified as a predictor for post-screening colorectal cancer. However, whether low-risk findings removed by an endoscopist with a lower dynamic ADR benefit from a shorter duration of follow-up requires further research.

Methods

We conducted a two-center retrospective study of individuals who had low-risk findings removed and underwent subsequent surveillance colonoscopy. Endoscopists’ dynamic ADR was the ADR of the previous 100 screening colonoscopies performed by the same endoscopist. A Cox-regression model and Kaplan–Meier survival analysis were used to explore the relationship between dynamic ADR and metachronous advanced colorectal neoplasia (ACRN).

Results

Totally, 3471 individuals who had low-risk findings removed in baseline colonoscopy were included in analysis. Decreasing endoscopists’ dynamic ADR was independently associated with metachronous ACRN. A 3.97-, 2.21-, and 2.67-fold increased risk for metachronous ACRN was observed in individuals of which baseline colonoscopy was performed by an endoscopist with a dynamic ADR of < 15%, 15–19%, and 20–24%, respectively, compared with those with the highest dynamic ADR (≥ 25%). The cumulative incidence of metachronous ACRN reached the 5% threshold at 4.5 years, 7.3 years, and 6.2 years in the dynamic ADR < 15%, 15–19%, and 20–24% group, respectively.

Conclusion

Endoscopists’ dynamic ADR influences the risk of metachronous ACRN after removal of low-risk findings in screening colonoscopy. Individuals undergoing removal of low-risk findings in screening colonoscopy by an endoscopist with a dynamic ADR < 25% may benefit from a shorter duration of follow-up interval.