Gastroenterology Outcomes

Quality in colonoscopy screening can be measured by the adenoma detection rate or ADR. This is the percentage of patients who had at least one adenoma detected during a screening colonoscopy. An adenoma is a type of polyp that has a high potential to become colorectal cancer.

Currently, recommendations from multiple medical societies for average-risk patients suggest an ADR of at least 20 percent for women and at least 30 percent for men. At PAMF, our doctors have an ADR of 33 percent for average-risk women and 42 percent for average-risk men. This is an 18 percentage point increase in adenoma detection for women, and a 17 percentage point increase in adenoma detection for men, as compared to the national benchmark.

According to a 2014 study published in the New England Journal of Medicine, each 1 percent increase in the adenoma detection rate is associated with a 3 percent decrease in colorectal cancer risk.

Colonoscopy is the primary screening tool for colorectal cancer. The ADR is tightly linked with the prevention of colon cancer, since any adenomas that are missed during colonoscopy could potentially become cancerous in the interval between screenings. This is why a higher ADR generally means a lower risk of cancer within the next five to 10 years after the screening.

Current guidelines state people should have their first colonoscopy at age 50 and one every 10 years thereafter if they have no special risk factors for colon cancer. Individuals with advanced polyps before age 60 may need to be screened earlier or more frequently. If a relative has had colon cancer, or if you have inflammatory bowel diseases such as Crohn’s disease, Lynch disease or ulcerative colitis, you may need a colonoscopy earlier or more often.

The following chart shows that more than 6,800 PAMF patients benefited from a screening colonoscopy in 2015 in which one or more adenomas were detected, besting national statistics. The data shows the percentage of patients by gender who received colonoscopies where adenomas were detected versus the national benchmark.

Data without personal identification is excerpted from patient records within 60 days of the colonoscopy procedure. Patients are considered average-risk if they had a screening colonoscopy only, have no personal or family history of colorectal cancer or polyps, and do not have Crohn’s disease or ulcerative colitis.