Hermann Brenner1, Lutz Altenhofen2, Jens Kretschmann2, Thomas Rösch3, Christian Pox4, Christian Stock5, Michael Hoffmeister6. 1. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany. Electronic address: h.brenner@dkfz.de. 2. Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany. 3. Interdisciplinary Endoscopy Department and Clinic, University Clinic Hamburg, Hamburg, Germany. 4. Department of Medicine, Ruhr University Bochum, Knappschaftskrankenhaus, Germany. 5. Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany. 6. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Abstract
BACKGROUND & AIMS: The adenoma detection rate (ADR) is an important quality indicator of screening colonoscopy; it is inversely associated with risk of interval cancers and colorectal cancer mortality. We assessed trends in the ADR in the first 10 years of the German screening colonoscopy program. METHODS: We calculated age-adjusted and age-specific detection rates of nonadvanced adenomas and advanced adenomas for each calendar year based on 4.4 million screening colonoscopies conducted from 2003 through 2012 and reported to the German screening colonoscopy registry. RESULTS: We observed a steady and strong increase in rate of detection of nonadvanced adenomas in both sexes and all age groups. Age-adjusted rates of detection of nonadvanced adenomas increased from 13.3% to 22.3% among men and from 8.4% to 14.9% among women. This increase was mostly due to an increase in detection rates of adenomas <0.5 cm, and it is partly explained by an innovation effect (higher ADRs among incoming colonoscopists than among leaving colonoscopists, and relatively stable ADRs among continuing colonoscopists). Only modest increases were observed in detection rates of advanced adenomas (from 7.4% to 9.0% among men, and from 4.4% to 5.2% among women) and colorectal cancer. In 2012, overall ADR reached 31.3% and 20.1% in men and women, respectively. CONCLUSIONS: We observed a strong increase in ADRs from 2003 through 2012 in Germany. Although we cannot exclude the effects of secular trends in colorectal neoplasm prevalence, the observed increase was mainly the result of a steady increase in detection of nonadvanced adenomas (especially adenomas <0.5 cm). Further research should address potential implications for defining screening and surveillance intervals.
BACKGROUND & AIMS: The adenoma detection rate (ADR) is an important quality indicator of screening colonoscopy; it is inversely associated with risk of interval cancers and colorectal cancer mortality. We assessed trends in the ADR in the first 10 years of the German screening colonoscopy program. METHODS: We calculated age-adjusted and age-specific detection rates of nonadvanced adenomas and advanced adenomas for each calendar year based on 4.4 million screening colonoscopies conducted from 2003 through 2012 and reported to the German screening colonoscopy registry. RESULTS: We observed a steady and strong increase in rate of detection of nonadvanced adenomas in both sexes and all age groups. Age-adjusted rates of detection of nonadvanced adenomas increased from 13.3% to 22.3% among men and from 8.4% to 14.9% among women. This increase was mostly due to an increase in detection rates of adenomas <0.5 cm, and it is partly explained by an innovation effect (higher ADRs among incoming colonoscopists than among leaving colonoscopists, and relatively stable ADRs among continuing colonoscopists). Only modest increases were observed in detection rates of advanced adenomas (from 7.4% to 9.0% among men, and from 4.4% to 5.2% among women) and colorectal cancer. In 2012, overall ADR reached 31.3% and 20.1% in men and women, respectively. CONCLUSIONS: We observed a strong increase in ADRs from 2003 through 2012 in Germany. Although we cannot exclude the effects of secular trends in colorectal neoplasm prevalence, the observed increase was mainly the result of a steady increase in detection of nonadvanced adenomas (especially adenomas <0.5 cm). Further research should address potential implications for defining screening and surveillance intervals.
Authors: Anne F Peery; Katherine S Cools; Paula D Strassle; Sarah K McGill; Seth D Crockett; Aubrey Barker; Mark Koruda; Ian S Grimm Journal: Gastroenterology Date: 2018-01-06 Impact factor: 22.682
Authors: Michal F Kaminski; Siwan Thomas-Gibson; Marek Bugajski; Michael Bretthauer; Colin J Rees; Evelien Dekker; Geir Hoff; Rodrigo Jover; Stepan Suchanek; Monika Ferlitsch; John Anderson; Thomas Roesch; Rolf Hultcranz; Istvan Racz; Ernst J Kuipers; Kjetil Garborg; James E East; Maciej Rupinski; Birgitte Seip; Cathy Bennett; Carlo Senore; Silvia Minozzi; Raf Bisschops; Dirk Domagk; Roland Valori; Cristiano Spada; Cesare Hassan; Mario Dinis-Ribeiro; Matthew D Rutter Journal: United European Gastroenterol J Date: 2017-03-16 Impact factor: 4.623
Authors: C Schramm; I Scheller; J Franklin; M Demir; F Kuetting; D Nierhoff; T Goeser; U Toex; H M Steffen Journal: United European Gastroenterol J Date: 2016-10-13 Impact factor: 4.623
Authors: Ravi K Amaravadi; Kathryn E Hamilton; Xiaohong Ma; Shengfu Piao; Armando Del Portillo; Katherine L Nathanson; Matteo S Carlino; Georgina V Long; Igor Puzanov; Xiaowei Xu; Jennifer J D Morrissette; Kenneth Y Tsai; Keith T Flaherty; Jeffrey A Sosman; Grant R Goodman; Grant A McArthur; Anil K Rustgi; David C Metz; Lynn M Schuchter; Paul B Chapman; Antonia R Sepulveda Journal: Clin Cancer Res Date: 2015-07-22 Impact factor: 12.531
Authors: Diantha Terlouw; Manon Suerink; Sunny S Singh; Hans J J P Gille; Frederik J Hes; Alexandra M J Langers; Hans Morreau; Hans F A Vasen; Yvonne J Vos; Tom van Wezel; Carli M Tops; Sanne W Ten Broeke; Maartje Nielsen Journal: Eur J Hum Genet Date: 2019-09-16 Impact factor: 4.246
Authors: Kevin J Monahan; Nicola Bradshaw; Sunil Dolwani; Bianca Desouza; Malcolm G Dunlop; James E East; Mohammad Ilyas; Asha Kaur; Fiona Lalloo; Andrew Latchford; Matthew D Rutter; Ian Tomlinson; Huw J W Thomas; James Hill Journal: Gut Date: 2019-11-28 Impact factor: 23.059