Factors associated with adenoma detection rate and diagnosis of polyps and colorectal cancer during colonoscopy in France: results of a prospective, nationwide survey.

<h4>Introduction</h4>Colonoscopy can prevent deaths due to colorectal cancer (CRC) through early diagnosis or resection of colonic adenomas. We conducted a prospective, nationwide study on colonoscopy practice in France.<h4>Methods</h4>An online questionnaire was administered...

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Autores principales: Maximilien Barret, Christian Boustiere, Jean-Marc Canard, Jean-Pierre Arpurt, David Bernardini, Philippe Bulois, Stanislas Chaussade, Denis Heresbach, Isabelle Joly, Jean Lapuelle, René Laugier, Gilles Lesur, Patrice Pienkowski, Thierry Ponchon, Bertrand Pujol, Bruno Richard-Molard, Michel Robaszkiewicz, Rémi Systchenko, Fatima Abbas, Anne-Marie Schott-Pethelaz, Christophe Cellier, Société Française d'Endoscopie Digestive
Formato: article
Lenguaje:EN
Publicado: Public Library of Science (PLoS) 2013
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Acceso en línea:https://doaj.org/article/508219d3c68143ce91858749d2dad525
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Sumario:<h4>Introduction</h4>Colonoscopy can prevent deaths due to colorectal cancer (CRC) through early diagnosis or resection of colonic adenomas. We conducted a prospective, nationwide study on colonoscopy practice in France.<h4>Methods</h4>An online questionnaire was administered to 2,600 French gastroenterologists. Data from all consecutive colonoscopies performed during one week were collected. A statistical extrapolation of the results to a whole year was performed, and factors potentially associated with the adenoma detection rate (ADR) or the diagnosis of polyps or cancer were assessed.<h4>Results</h4>A total of 342 gastroenterologists, representative of the overall population of French gastroenterologists, provided data on 3,266 colonoscopies, corresponding to 1,200,529 (95% CI: 1,125,936-1,275,122) procedures for the year 2011. The indication for colonoscopy was CRC screening and digestive symptoms in 49.6% and 38.9% of cases, respectively. Polypectomy was performed in 35.5% of cases. The ADR and prevalence of CRC were 17.7% and 2.9%, respectively. The main factors associated with a high ADR were male gender (p=0.0001), age over 50 (p=0.0001), personal or family history of CRC or colorectal polyps (p<0.0001 and p<0.0001, respectively), and positive fecal occult blood test (p=0.0005). The prevalence of CRC was three times higher in patients with their first colonoscopy (4.2% vs. 1.4%; p<0.0001).<h4>Conclusions</h4>For the first time in France, we report nationwide prospective data on colonoscopy practice, including histological results. We found an average ADR of 17.7%, and observed reduced CRC incidence in patients with previous colonoscopy.