Does Fellow Participation Increase the Adenoma Detection Rate?

Excerpt

The primary operator-dependent quality indicator for colonoscopy is the adenoma detection rate (ADR), defined as the proportion of screening colonoscopies detecting at least one adenoma, which ideally should be ≥ 25% overall (≥ 30 for male patients and ≥ 20% for female patients) [1]. In fact, the ADR is inversely related to both the risk of interval colorectal cancer (cancer diagnosed on a surveillance exam after an initial negative screening colonoscopy), as well as death caused by interval colorectal cancer [2, 3]. Several factors affect the ADR, including: (1) patient features such as age, gender, and family history; (2) procedural characteristics such as optimized colon cleansing, withdrawal time, and methods of sedation; (3) ancillary maneuvers such as positioning, right colon retroflexion, and the use of water-aided methods; (4) technologic advances such as new generation endoscopes, increased field of view, add-on tools, virtual chromoendoscopy, and artificial intelligence; and (5) endoscopist experience [4, 5]. …