Observational study of association of improved adenoma detection rates by physicians and subsequent colorectal cancer risk

Patients of physicians with higher adenoma detection rates (ADRs) during colonoscopy have lower colorectal cancer (CRC) risk after screening colonoscopy (ie, postcolonoscopy CRC). An observational study in Poland investigated the association between improvement in ADR with a range of ADR values at baseline with CRC incidence among their patients. The study included 789 physicians with a median ADR at baseline of 21.8%, who performed 485,615 colonoscopies between 2000 and 2017. The incidence of CRC after colonoscopy was lower in patients of physicians whose ADR improved from an baseline of less than 26%, compared with patients of physicians whose ADR did not improve from a baseline of less than 26% (difference, 8.9/100,000 person-years). However, this phenomenon was not observed among patients of physicians whose baseline ADR was 26% or higher (difference, 0.9/100,000 person-years). The authors conclude that improved ADR among physicians was associated with lower CRC incidence in patients who underwent colonoscopy, but only among patients of physicians with a baseline ADR less than 26%.