Longer Withdrawal Time Is Associated with a Reduced Incidence of Interval Cancer After Screening Colonoscopy

Details

• Personal Author:
  Allen JI ; Church, Timothy R. ; Kim AS ; Lederle FA ; Rank JM ; Rector TS ; Shaukat A
• Description:
  Background & Aims: Withdrawal times and adenoma detection rates are widely used quality indicators for screening colonoscopy. More rapid withdrawal times have been associated with undetected adenomas, which can increase risk for interval colorectal cancer. Methods: We analyzed records of 76,810 screening colonoscopies performed between 2004 and 2009, by 51 gastroenterologists practicing in Minneapolis and St Paul, MN. Colonoscopy records were linked electronically to the state cancer registry (Minnesota Cancer Surveillance System) to identify incident interval cancers that were diagnosed within 5.5 years after the screening examination. Results: The physicians' mean +/- SD withdrawal time was 8.6 +/- 1.7 minutes and adenoma detection rates were 25% +/- 9%. Longer mean withdrawal times were associated with higher adenoma detection rates (3.6% per minute; 95% confidence interval: 2.4% to 4.8%; P < .0001). We identified 78 cancers during 410,687 person-years of follow-up, for an annual rate of 0.19/1000 person-years. Physicians' mean annual withdrawal times were inversely associated with cancer incidence (P < .0001). Compared with withdrawal times ?6 minutes, the adjusted incidence rate ratio for withdrawal times of <6 minutes was 2.3 (95% confidence interval: 1.5?3.4; P < .0001). Conclusions: Shorter mean annual withdrawal times during screening colonoscopies were independently associated with lower adenoma detection rates and increased risk of interval colorectal cancer. [Description provided by NIOSH]
• Subjects:
  Health Care Facilities Workforce And Services Neoplasms Occupational Health Safety
• Keywords:
  Author Keywords: IRR Cancer Rates Clinical Techniques Colon Cancer Colorectal Cancer CRC Early Detection Medical Monitoring Medical Screening Surveillance
• ISSN:
  0016-5085
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Connecticut ; Minnesota ; OSHA Region 1 ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  149
• Issue:
  4
• NIOSHTIC Number:
  nn:20064578
• Citation:
  Gastroenterology 2015 Oct; 149(4):952-957
• Contact Point Address:
  Aasma Shaukat, MD, MPH, Division of Gastroenterology, Minneapolis Veterans Affairs Health Care System, One Veterans Drive, 111-D, Minneapolis, Minnesota 55417
• Email:
  Shaukat@umn.edu
• Federal Fiscal Year:
  2016
• Performing Organization:
  University of Minnesota Twin Cities
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Gastroenterology
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:174ac99aff415a3d9a20e283ad227a4ffd6cbb4c1d53a8daabd555ca9ec57691929019618d7298e86d497b48ba3eee8014e043c9102569365f2418fbd52ccf3a
• Download URL:
  https://stacks.cdc.gov/view/cdc/223016/cdc_223016_DS1.pdf
• File Type:
  [PDF - 443.57 KB ]