Detection rates of XXXX during screening colonoscopy: Time to revise quality standards?

@entity1 @entity1127 @entity5 @entity75 @entity14 @entity652
BACKGROUND: Standards for the detection of @entity652 during screening colonoscopy are widely used to measure examination quality. No such standards exist for sessile serrated @entity652 (SSAs). OBJECTIVE: To measure both the @entity652 detection rate (ADR) and SSA detection rate (SSADR) during screening colonoscopy before and after quality improvement/financial incentive measures. DESIGN: Retrospective determination of baseline ADR/SSADR by the endoscopist, followed by prospective collection of data after informing physicians of baseline detection rates. SETTING: Tertiary @entity5 center with a large @entity5 screening program. @entity1 : A total of 2833 average-risk @entity14 screening @entity1 50 to 75 years of age undergoing initial colonoscopy. DATA COLLECTION: Electronic medical records for indication and demographics, endoscopy report, and pathology report. MAIN OUTCOME MEASUREMENTS: Detection rates of @entity652 and SSAs by sex. RESULTS: The overall ADR in male and female @entity1 was 50.6% and 36.6%, respectively. The overall detection rate of advanced @entity652 in male and female @entity1 was 12.4% and 6.5%, respectively. The overall SSADR in  male and female @entity1 was 10.1% and 7.1%, respectively. In 108 @entity1 (3.8% of entire group), SSAs were the only @entity75 found. Detection rates of both types of @entity1127 improved over time but did not reach statistical significance. LIMITATIONS: Single-center experience with limited sample size and small group of endoscopists. CONCLUSION: ADRs far in excess of current standards are achievable. Cecal withdrawal time is associated with the  ADR. Prevalence of SSA rivals that of advanced @entity652 and is greater than current medical literature suggests. The combination of monitoring and financial incentives did not result in statistically significant improvement in ADRs.
