Increased adenoma detection rate may significantly reduce post-colonoscopy colorectal cancer risk in a FIT-based screening program
A cohort study from the Italian Colorectal Cancer screening program including more than 49,000 colonoscopies found a significant inverse association between endoscopists’ proficiency as measured by adenoma detection rate (ADR) and post-colonoscopy colorectal cancer (PCCRC). These finding suggest that targeting only poor performing endoscopists with measures to increase ADR may significantly reduce PCCRC risk. The findings are published in Annals of Internal Medicine.
Colorectal cancer (CRC) population screening programs based on fecal testing (FITs) represent the standard of care for CRC prevention in many Western countries. The ultimate effectiveness of these screening procedures relies on the accurate detection and removal of precancerous lesions and early invasive cancer in colonoscopies of persons with positive FIT results. However, it is known that there are high miss rates and high rates of performance variability among endoscopists.
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