High-Volume Colonoscopy Predicts Higher Cecal Intubation Rates and Lower Perforation Risk, but Not Higher Detection or Cancer Prevention
Douglas K. Rex, MD, MASGE
reviewing Forbes N, et al. Clin Gastroenterol Hepatol 2020 Mar 20.
In a systematic review and meta-analysis encompassing 27 studies with 11,276,244 colonoscopies, there was no association of procedure volume with adenoma detection rate (ADR) nor prevention of postcolonoscopy cancer. The cecal intubation rate increased with each additional 100 annual procedures (odds ratio [OR], 1.17). Overall adverse events trended lower with each 100 annual procedures (OR, 0.95; 95% confidence interval, 0.90-1.00). The risk of perforation appeared more clearly reduced, based on two large studies that had specifically examined this, with 8% and 4% risk reductions per 100 additional annual procedures.
Note to readers:
At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
Forbes N, Boyne DJ, Mazurek MS, et al. Association between endoscopist annual procedure volume and colonoscopy quality: systematic review and meta-analysis. Clin Gastroenterol Hepatol
2020 Mar 20. (Epub ahead of print) (https://doi.org/10.1016/j.cgh.2020.03.046