10 Things to Know About Adenoma Detection

Here are 10 things to know about adenoma detection.

1. A physician's "adenoma detection rate" is used as a colonoscopy quality indicator. ADR is defined as the percentage of patients for which the physician detected at least one adenoma, according to the American College of Gastroenterology.

2. To hit benchmark, a physician's ADR should be at least 25 percent for male patients and 15 percent for female patients. The most effective way to increase a physician's ADR may be additional education and training, rather than changes in technology, according to a 2013 study in Nature.

3. Screening guidelines from the American College for Gastroenterology for colonoscopy note:

  • Patients with more than 10 adenomas should receive another colonoscopy in less than three years.
  • Those with between three and 10 tubular adenomas, at least one large tubular adenoma or at least one villous adenoma should receive another colonoscopy in three years.
  • Those with one or two small tubular adenomas should receive another colonoscopy in five to 10 years.

4. By detecting adenomas and other precancerous polyps, screenings prevented about half of the expected new cases and deaths from colorectal cancer between 2003 and 2007, according to a 2011 CDC report.

5. The average gastroenterologist performs 21 colonoscopies a month, 45.8 percent of which are dedicated to screening, according to a 2004 study in the journal Alimentary Pharmacology & Therapeutics and reported in Medscape. The study also estimated that around 1.69 million patients receive screening-related colonoscopies each year, 1.27 million of which are performed by gastroenterologists.

6. The study in Alimentary Pharmacology & Therapeutics concluded that there are not enough gastroenterologists to meet patient demand, since the annual demand for colonoscopy ranges from 2.21 million to 7.96 million. The study goes on to say that 1,360 gastroenterologists would need to be added to meet this demand.

7. Total annual compensation for gastroenterologists is $370,000, ranking the third highest-paid medical specialty, according to the Medscape Gastroenterologist Compensation Report 2015.

8. While gastroenterologists, general surgeons and primary care physicians might perform colonoscopies, studies have shown that gastroenterologists tend to provide higher quality care in three areas of performance: they are less likely to miss colorectal cancer, less likely to have complications and more likely to hit quality guidelines, according to the American College of Gastroenterology.

9. Colonoscopies are the most expensive screening test that healthy Americans regularly receive, according to the New York Times. Without additional charges included, the average price for a colonoscopy in the United States in 2012 was $1,185.

10. A controversial issue is physician and patients' preferred method of colorectal cancer screening. While colonoscopy is the standard method, other techniques have also proven accurate in recent studies. In a 2008 study in the New England Journal of Medicine, CT colonography (or "virtual colonoscopy") identified 90 percent of subjects with adenomas or cancers measuring 10 millimeters or more in diameter.

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