ASGE Press Releases
For Immediate Release
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Detection of Precancerous Polyps During Colonoscopy Related to Withdrawal Time
Oak Brook, Ill. -December 13, 2006 -- A study published in this week's issue of the New England Journal of Medicine reported that withdrawal time of the colonoscope during a colonoscopy is related to detection rates of adenomas (or precancerous polyps). The research, titled "Colonoscopic Withdrawal Times and Adenoma Detection during Screening Colonoscopy," looked at 7882 colonoscopies performed by 12 experienced endoscopists over a 15-month period. This new study substantiates a recent guideline of the American Society for Gastrointestinal Endoscopy, "Quality Indicators for Colonoscopy," which was published as a supplement in the April 2006 issue of Gastrointestinal Endoscopy. In "Quality Indicators for Colonoscopy," experts identified increased detection of significant neoplastic lesions in colonoscopic examinations where the withdrawal time is 6 minutes or more and concluded that withdrawal time is an appropriate quality indicator.
In this new study, led by Robert L. Barclay, MD, of Rockford Gastroenterology Associates, Rockford, Ill., the investigators compared the rates of detection of neoplastic lesions (newly formed, abnormal tissue) among gastrointestinal endoscopists who had mean withdrawal times of less than 6 minutes with the rates of those who had mean withdrawal times of 6 minutes or more. The authors found that those endoscopists with colonoscope withdrawal times greater than six minutes had detection rates for neoplasia over 28 percent, whereas those with mean withdrawal times of less than 6 minutes had detection rates under 12 percent. The authors conclude that variation of withdrawal times may affect the prevention of colorectal cancer as it relates to routine screenings.
"The significance of this study for the field of gastrointestinal endoscopy goes beyond its findings. This research demonstrates the ability of private practitioners to measure quality indicators in their practice and identify areas for improvement. There is a perception that evaluating the quality of procedures is unrealistic within the practice setting. In other words, that it is only feasible for academicians in institutions. This study provides an example of how measuring quality indicators can lead to improvement in practice. This should become part of the culture of every practice," said David Lieberman, MD, FASGE, Chief, Division of Gastroenterology at Oregon Health & Science State University, Portland, Ore.
"Colonoscopy plays a crucial role in the fight to prevent colon cancer and for the successful diagnosis and treatment of a wide variety of digestive health conditions. Setting evidence-based standards for quality colonoscopy continues to be a focus for ASGE," said Gary W. Falk, MD, MS, ASGE president and Professor of Medicine at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University.
Colon cancer is the second most common cause of cancer deaths in the United States, killing nearly 56,000 people each year. Many of these deaths could be prevented through early detection with proper screening. Unfortunately, more than 60 percent of Americans aged 50 or older -- approximately 42 million people -- have not utilized any screening method for colorectal cancer.
Colonoscopy is widely accepted as the most effective method for colon cancer screening because it allows the trained physician to thoroughly evaluate the entire colon. In addition, it is the only screening method that enables the physician to remove benign adenomatous polyps before they progress to become cancerous. The ASGE screening guidelines recommend that, beginning at age 50, both men and women at average risk for developing colorectal cancer should have a colonoscopy every 10 years. People with higher risk factors, such as a family history of colon cancer, should begin earlier. Patients are advised to discuss their risk factors with their physician to determine when to begin routine colorectal cancer screening and how often they should be screened.
For more information about colorectal cancer screening or to find a qualified endoscopist, visit ASGE's colorectal cancer awareness Web site at www.screen4coloncancer.org. To learn more about ASGE's "Quality Indicators for Colonoscopy" guideline, visit www.asge.org/pressroomindex.aspx?id=532.
About the American Society for Gastrointestinal Endoscopy
The American Society for Gastrointestinal Endoscopy (ASGE), founded in 1941, is the preeminent professional organization dedicated to advancing the practice of endoscopy. ASGE, with more than 9,500 physician members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. Visit www.asge.org; www.askasge.org; and www.screen4coloncancer.org for more information.