Abstract

Objective: To observe polyp/adenoma detection rate of sigmoidoscopy among doctors with different skill level.

Method: 5 doctors examined healthy checkups respectively. Upon detection, diagnosis adenoma/non-adenoma according to Kudo classification. Recommend total colonoscopy (TC) resection for adenomas.

Results: 1666 healthy checkups examined. 201 resection recommendations were made, and 120 actually received TC adenoma resection. All doctors finish sigmoidoscopy successfully, with different intubation depth. Intubation depth is highly related with prior finished TC number of the doctor. R value is 0.7593 for reaching descending, 0.9416 for transcending, 0.9786 for ascending colon. Total polyp detection rate 32.05%, adenoma detection rate (ADR) 12.06%. ADR vary significantly among doctors, from 9.39% to 17.36%. ADR also highly related with prior finished TC number, R = 0.8234. Adenoma diagnosis was verified with histology, from 72.73% to 91.67%. There is no difference among doctors, p = 0.9716. Total adenoma missing rate of sigmoidoscopy is 17.5%. There is no difference among doctors, p = 0.3898.

Conclusions: The ADR of sigmoidoscopy is fare. Skill level has important influence to ADR of sigmoidoscopy, but not diagnosis accuracy.

Keywords: Healthy Checkup; Sigmoidoscopy; Adenoma Detection Rate; Kudo Classification

References

1. Winawer SJ., et al. “Cascade colorectal cancer screening guidelines: a global conceptual model”. Journal of Clinical Gastroenterology4 (2011): 297-300.
2. Jover R., et al. “Clinical practice guidelines: quality of colonoscopy in colorectal cancer screening”. Endoscopy4 (2012): 444-451.
3. Qaseem A., et al. “Screening for colorectal cancer: a guidance statement from the American College of Physicians”. Annals of Internal Medicine5 (2012): 378-386.
4. S. Preventive Services Task Force. “Screening for colorectal cancer: recommendation and rationale”. Annals of Internal Medicine 137.2 (2002): 129-131.
5. S. Preventive Services Task Force. “Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement”. Annals of Internal Medicine 149.9 (2008): 627-637.
6. Rex DK., et al. “Quality indicators for colonoscopy”. The American Journal of Gastroenterology4 (2006): 873-885.
7. Rogal SS., et al. “Relationship between Detection of Adenomas by Flexible Sigmoidoscopy and Interval Distal Colorectal Cancer”. Clinical Gastroenterology and Hepatology 1 (2013): 73-78.
8. Zheng Jingquan., et al. “Epidemiological study on the incidence of colorectal cancer in Pudong New Area, Shanghai”. Chronic Disease Prevention and Control in China 3 (2003): 110-135.
9. Levin B., et al. “Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology”. CA: A Cancer Journal for Clinicians3 (2008): 130-160.
10. Holme Ø., et al. “Effect of flexible sigmoidoscopy screening on colorectal cancer incidence and mortality: a randomized clinical trial”. JAMA6 (2014): 606-615.
11. Chen SC and Rex DK. “Endoscopist can be more powerful than age and male gender in predicting adenoma detection at colonoscopy”. The American Journal of Gastroenterology4 (2007): 856-861.
12. Schoenfeld P., et al. “Accuracy of polyp detection by gastroenterologists and nurse endoscopists during flexible sigmoidoscopy: a randomized trial”. Gastroenterology2 (1999): 312-318.
13. Huang Yinglong., et al. “The missed diagnosis rate and risk factors of colorectal adenoma in colonoscopy”. Chinese Journal of Digestive Endoscopy 6 (2010): 281-286.
14. Bruno M. “Magnification endoscopy, high resolution endoscopy, and chromoscopy; towards a better optical diagnosis”. Gut 52 (2003): iv7-11.
15. Rex DK., et al. “Serrated Lesions of the Colorectum: Review and Recommendations From an Expert Panel”. The American Journal of Gastroenterology9 (2012): 1315-1330.

Citation

Citation: Ouyang Hong.,et al. “Train Young Colonoscopist with Sigmoidoscopy - Performance, Adenoma Detection Rate and More”.Acta Scientific Medical Sciences 5.11 (2021): 71-75.

Copyright

Copyright: © 2021 Ouyang Hong.,et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.