Adenoma Detection Rate Inversely Linked to Postcolonoscopy CRC

Inverse association seen for ADR with postcolonoscopy colorectal cancer incidence risk in FIT-based screening program setting
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Medically Reviewed By:
Meeta Shah, M.D.

WEDNESDAY, Feb. 22, 2023 (HealthDay News) -- Adenoma detection rate (ADR) is associated with the postcolonoscopy colorectal cancer (PCCRC) rate in a fecal immunochemical test (FIT)-based screening setting, according to a study published online Feb. 21 in the Annals of Internal Medicine.

Manuel Zorzi, M.D., from the Veneto Tumor Registry in Padova, Italy, and colleagues conducted a retrospective cohort study involving patients with a positive FIT result who underwent colonoscopy. The ADR of endoscopists was classified into groups: 20 to 39.9 percent, 40 to 44.9 percent, 45 to 49.9 percent, 50 to 54.9 percent, and 55 to 70 percent. The association between ADR and PCCRC risk was examined.

Data were included for 49,626 colonoscopies done by 113 endoscopists between 2012 and 2017. A total of 277 PCCRC cases were diagnosed after 328,778 person-years of follow-up. The researchers found that the mean ADR was 48.3 percent, ranging from 23 to 70 percent. From lowest to highest ADR categories, the incidence rates of PCCRC were 13.13, 10.61, 7.60, 6.01, and 5.78 per 10,000 person-years, respectively. A significant inverse association was seen between ADR and PCCRC incidence risk; compared with the highest group, the lowest group had a 2.35-fold increased risk. Each 1 percent increase in ADR was associated with an adjusted hazard ratio of 0.96 for PCCRC.

"Our data showed a graded inverse association of ADR with PCCRC and interval CRC incidence risks in a FIT-based screening program, confirming in this population-based setting previous evidence from non-FIT settings and the only previous study done in a FIT-based setting," the authors write.

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