Adenoma Detection Rates by Physicians and Subsequent Colorectal Cancer Risk

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Abstract

Importance

Patients of physicians with higher adenoma detection rates (ADRs) during colonoscopy have lower colorectal cancer (CRC) risk after screening colonoscopy (ie, postcolonoscopy CRC). Among physicians with an ADR above the recommended threshold, it is unknown whether improving ADR is associated with a lower incidence of CRC in their patients.

Objective

To determine the association of improved ADR in physicians with a range of ADR values at baseline with CRC incidence among their patients.

Design, Setting, and Participants

A total of 789 physicians in the Polish Colonoscopy Screening Program were studied between 2000 and 2017, with final follow-up on December 31, 2022. Joinpoint regression analyses were used to identify trends between changes in ADR and postcolonoscopy CRC incidence. Rates of CRC after colonoscopy were compared between physicians whose ADR improved and those without improvement. ADR improvement was defined as either an improvement by at least 1 ADR sextile category or remaining in the highest category.

Exposure

Physician ADR.

Main Outcomes and Measures

Association of improved ADR with postcolonoscopy CRC incidence.

Results

Of 485 615 patients (mean [SD] age, 57 [5.41] years; 60% female), 1873 CRC diagnoses and 474 CRC-related deaths occurred during a median follow-up of 10.2 years. Among individual physicians at baseline, median (IQR) ADR was 21.8% (15.9%-28.2%) and maximum ADR was 63.0%. Joinpoint regression showed a change in CRC incidence trends at an ADR level of 26%, corresponding to a CRC incidence of 27.1 per 100 000 person-years. Patients of physicians whose ADR was less than 26% at baseline and improved during follow-up had a postcolonoscopy CRC incidence of 31.8 (95% CI, 29.5-34.3) per 100 000 person-years, compared with 40.7 (95% CI, 37.8-43.8) per 100 000 person-years for patients of physicians with an ADR of less than 26% at baseline who did not improve during follow-up (difference, 8.9/100 000 person-years [95% CI, 5.06-12.74]; P &lt; .001). Patients of physicians whose ADR was above 26% at baseline and improved during follow-up had a postcolonoscopy CRC incidence of 23.4 (95% CI, 18.4-29.8) per 100 000 person-years, compared with 22.5 (95% CI, 18.3-27.6) for patients of physicians whose ADR was above 26% at baseline and did not improve during follow-up (difference, 0.9/100 000 person-years [95% CI, −6.46 to 8.26]; P = .80).

Conclusions and Relevance

In this observational study, improved ADR over time was statistically significantly associated with lower CRC risk in patients who underwent colonoscopy compared with absence of ADR improvement, but only among patients whose physician had a baseline ADR of less than 26%.

Related collections

Most cited references 24

Record: found
Abstract: found
Article: not found

Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

Hyuna Sung, Jacques Ferlay, Rebecca Siegel … (2021)

This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.

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Record: found
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Article: not found

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.

Erik von Elm, Douglas G. Altman, Matthias Egger … (2008)

Much of biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalizability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. Eighteen items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.

0 comments Cited 3534 times – based on 0 reviews      Review now

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Record: found
Abstract: not found
Article: not found

Permutation tests for joinpoint regression with applications to cancer rates

Hyune-Ju Kim, Michael P. Fay, Eric Feuer … (2000)

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Author and article information

Journal

Title: JAMA

Abbreviated Title: JAMA

Publisher: American Medical Association (AMA)

ISSN (Print): 0098-7484

Publication date Created: February 04 2025

Publication date (Print): February 04 2025

Volume: 333

Issue: 5

Page: 400

Affiliations

[1 ]Department of Gastroenterological Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland

[2 ]Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway

[3 ]Department of Surgical Oncology, Transplant Surgery and General Surgery, Medical University of Gdańsk, Gdańsk, Poland

[4 ]Centre of Postgraduate Medical Education, Warsaw, Poland

[5 ]Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway

[6 ]Polish National Cancer Registry, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland

[7 ]Department of Interdisciplinary Endoscopy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

Article

DOI: 10.1001/jama.2024.22975

SO-VID: 086743e6-563c-45b5-a3d6-3278ad82974b

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