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Time-of-day variation in the diagnostic quality of screening colonoscopies: a registry-based study

BACKGROUND: The diagnostic quality of screening colonoscopies has been found to differ between morning and afternoon. Specifically, the adenoma detection rate (ADR) is higher in the morning. Our aim was to assess if time-of-day dependent differences in colonoscopy quality exist in a Danish screening...

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Autores principales: Jaho, File, Kroijer, Rasmus, Ploug, Magnus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hellenic Society of Gastroenterology 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8596217/
https://www.ncbi.nlm.nih.gov/pubmed/34815647
http://dx.doi.org/10.20524/aog.2021.0668
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author Jaho, File
Kroijer, Rasmus
Ploug, Magnus
author_facet Jaho, File
Kroijer, Rasmus
Ploug, Magnus
author_sort Jaho, File
collection PubMed
description BACKGROUND: The diagnostic quality of screening colonoscopies has been found to differ between morning and afternoon. Specifically, the adenoma detection rate (ADR) is higher in the morning. Our aim was to assess if time-of-day dependent differences in colonoscopy quality exist in a Danish screening setting. Following national screening guidelines, an individual will be exempt from screening invitations for 8 years if the colonoscopy is without pathology. Therefore, it is of utmost importance to identify factors systematically affecting the detection of lesions. METHODS: This was a single-center study of screening colonoscopies performed between 2014 and 2018. Records were retrieved from the Danish Colorectal Cancer Screening Database and coupled with local data. The ADR and the cecal intubation rate were compared between morning (8-12 a.m.) and afternoon (12-4 p.m.) colonoscopies. Multivariate logistic regression analysis was performed. RESULTS: A total of 3659 screening colonoscopies were included. The ADR was 51% in the morning and 58% in the afternoon. Multivariate analysis found this statistically significant, with the “afternoon vs. morning” odds ratio for adenoma detection being 1.4 (95% confidence interval 1.17-1.68; P<0.001). The cecal intubation rate was 95.6% in the morning and 94.7%, a non-significant difference. CONCLUSIONS: The ADR of screening colonoscopies was higher in the afternoon. Our study highlights the need for local/regional evaluation of factors affecting colonoscopy quality to address such issues. A clean colonoscopy exempts the patient from subsequent screening invitations for 8 years. Therefore, any observed systematic differences in quality must be addressed and eliminated.
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spelling pubmed-85962172021-11-22 Time-of-day variation in the diagnostic quality of screening colonoscopies: a registry-based study Jaho, File Kroijer, Rasmus Ploug, Magnus Ann Gastroenterol Original Article BACKGROUND: The diagnostic quality of screening colonoscopies has been found to differ between morning and afternoon. Specifically, the adenoma detection rate (ADR) is higher in the morning. Our aim was to assess if time-of-day dependent differences in colonoscopy quality exist in a Danish screening setting. Following national screening guidelines, an individual will be exempt from screening invitations for 8 years if the colonoscopy is without pathology. Therefore, it is of utmost importance to identify factors systematically affecting the detection of lesions. METHODS: This was a single-center study of screening colonoscopies performed between 2014 and 2018. Records were retrieved from the Danish Colorectal Cancer Screening Database and coupled with local data. The ADR and the cecal intubation rate were compared between morning (8-12 a.m.) and afternoon (12-4 p.m.) colonoscopies. Multivariate logistic regression analysis was performed. RESULTS: A total of 3659 screening colonoscopies were included. The ADR was 51% in the morning and 58% in the afternoon. Multivariate analysis found this statistically significant, with the “afternoon vs. morning” odds ratio for adenoma detection being 1.4 (95% confidence interval 1.17-1.68; P<0.001). The cecal intubation rate was 95.6% in the morning and 94.7%, a non-significant difference. CONCLUSIONS: The ADR of screening colonoscopies was higher in the afternoon. Our study highlights the need for local/regional evaluation of factors affecting colonoscopy quality to address such issues. A clean colonoscopy exempts the patient from subsequent screening invitations for 8 years. Therefore, any observed systematic differences in quality must be addressed and eliminated. Hellenic Society of Gastroenterology 2021 2021-10-12 /pmc/articles/PMC8596217/ /pubmed/34815647 http://dx.doi.org/10.20524/aog.2021.0668 Text en Copyright: © Hellenic Society of Gastroenterology https://creativecommons.org/licenses/by-nc-sa/3.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Jaho, File
Kroijer, Rasmus
Ploug, Magnus
Time-of-day variation in the diagnostic quality of screening colonoscopies: a registry-based study
title Time-of-day variation in the diagnostic quality of screening colonoscopies: a registry-based study
title_full Time-of-day variation in the diagnostic quality of screening colonoscopies: a registry-based study
title_fullStr Time-of-day variation in the diagnostic quality of screening colonoscopies: a registry-based study
title_full_unstemmed Time-of-day variation in the diagnostic quality of screening colonoscopies: a registry-based study
title_short Time-of-day variation in the diagnostic quality of screening colonoscopies: a registry-based study
title_sort time-of-day variation in the diagnostic quality of screening colonoscopies: a registry-based study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8596217/
https://www.ncbi.nlm.nih.gov/pubmed/34815647
http://dx.doi.org/10.20524/aog.2021.0668
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