Different bowel preparation schedule leads to different diagnostic yield of proximal and nonpolypoid colorectal neoplasm at screening colonoscopy in average-risk population
Journal
Diseases of the Colon and Rectum
Journal Volume
54
Journal Issue
12
Pages
1570-1577
Date Issued
2011
Author(s)
Abstract
BACKGROUND: Accumulating evidence indicates that the timing of bowel preparation is crucial, but its impact on the diagnostic yield of proximal or nonpolypoid colorectal neoplasm remains unclear. OBJECTIVE: This study aimed to investigate the impact of the timing of bowel preparation on the adenoma detection rate for nonpolypoid colorectal neoplasm at colonoscopy. DESIGN: This study is a retrospective analysis of a screening colonoscopy cohort database. SETTING: The investigation was conducted at a screening colonoscopy unit in an university hospital. PATIENTS: A consecutive series of 3079 subjects who received primary screening colonoscopy with different timing of bowel preparation was analyzed. INTERVENTION: Different timing of bowel preparation (same day vs prior day) was studied. MAIN OUTCOME MEASURES: The main outcomes measured were patient demographics, timing of bowel preparation, colon-cleansing levels, diagnostic yields of colonoscopy, including adenoma, advanced adenoma, and nonpolypoid colorectal neoplasm. RESULTS: There were a total of 1552 subjects in the morning group and 1527 in the evening group. More subjects had proximal adenoma (175, 11.3% vs 138, 9.0%, P = .04), advanced adenoma (68, 4.4% vs 46, 13.0%, P = .044), nonpolypoid colorectal neoplasm (98, 6.3% vs 67, 4.4%, P = .018), proximal nonpolypoid colorectal neoplasm (71, 4.6% vs 40, 2.6%, P = .004), and advanced nonpolypoid colorectal neoplasm (25, 1.6% vs 12, 0.8%, P = .036) detected by same-day preparation. On multivariate regression analysis, the adenoma detection rate was significantly higher in the same-day group regarding overall and proximal adenoma (OR 1.23, 95% CI: 1.00-1.50; OR 1.35, 95% CI: 1.05-1.74), advanced adenoma (OR 1.53, 95% CI: 1.04-2.28), overall, proximal, and advanced nonpolypoid colorectal neoplasm (OR 1.48, 95% CI: 1.06-2.08; OR 1.82, 95% CI: 1.20-2.75; OR 1.96, 95% CI: 1.12-3.37). The adenoma detection rate was also significantly different among endoscopists. LIMITATION: This was a single-center, nonrandomized trial. CONCLUSIONS: Improving bowel preparation quality by same-day preparation may lead to enhanced detection of overall, proximal, and advanced nonpolypoid colorectal neoplasm. ?The ASCRS 2011.
SDGs
Other Subjects
adult; article; cancer risk; colon lavage; colonoscopy; colorectal adenoma; controlled study; diagnostic value; female; human; intestine preparation; major clinical study; male; screening test; treatment outcome; adenoma; colorectal tumor; drug administration; early diagnosis; middle aged; multivariate analysis; retrospective study; risk; time; laxative; Adenoma; Adult; Cathartics; Colonoscopy; Colorectal Neoplasms; Drug Administration Schedule; Early Detection of Cancer; Female; Humans; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Retrospective Studies; Time Factors
Type
journal article