Factors predicting the colorectal adenoma detection rate in colonoscopic screening of a Chinese population: A prospective study

Colorectal cancer has high incidence and mortality. Early diagnosis could increase patient survival, but early diagnosis has been poor in China for the past decades. The purpose of this study is to assess the polyp detection rate (PDR) and adenoma detection rate (ADR) by colonoscopy in a Chinese population, and to determine the risk factors for adenoma. This prospective study at Sichuan Provincial People's Hospital evaluated patients who underwent colonoscopy in September 2017 to February 2018. Basic information, exact insertion and withdrawal times, PDR, and ADR were assessed. Risk factors for colorectal adenoma in the adenoma-positive and adenoma-negative groups (based on pathology) were assessed by multivariable logistic regression analysis. A total of 1058 procedures with 767 polyps were analyzed. The overall PDR and ADR were 36.96% (391/1058) and 24.67% (261/1058), respectively. Occurrence of adenoma was associated with age, gender, body mass index (BMI), family history of colon cancer, personal history of adenoma, diabetes mellitus, and tobacco use. There was a significant association between withdrawal time and ADR (P < .001). In the multivariable analysis, age (OR = 1.041, 95%CI 1.028–1.055; P < .001), insertion time (OR = 0.999, 95%CI 0.998–1.000; P = .009), withdrawal time (OR = 1.009, 95%CI 1.007–1.011; P < .001), personal history of adenoma (OR = 2.572, 95%CI 1.115–5.932; P = .027), and diabetes mellitus (OR = 2.221, 95%CI 1.084–4.549; P = .029) were risk factors for colorectal adenoma detection. In a Chinese population, ADR increases with age, withdrawal time, a personal history of adenoma, and diabetes. Age, insertion and withdrawal times, and a personal history of adenoma may independently predict colorectal adenoma detection.