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Correlation between adenoma detection rate in colonoscopy- and fecal immunochemical testing-based colorectal cancer screening programs

Publicado en:United European Gastroenterology Journal. 5 (2): 255-260 - 2017-03-01 5(2), DOI: 10.1177/2050640616660662

Autores: Cubiella J; Castells A; Andreu M; Bujanda L; Carballo F; Jover R; Lanas Á; Morillas JD; Salas D; Quintero E; Lanas A; González-Rubio F; Moya-Calvo A; Polo-Tomas M; Roncales MP; Sebastian-Martínez P; Valencia-Doblas MÁ; Valero-Capilla N; Alkiza ME; Altzibar J; Amiano P; Arenas J; Artiñano E; Cosme A; Egitegi I; Elorriaga K; Elósegui JL; Enriquez-Navascués JM; Erce C; Gil I; Gutiérrez-Stampa MA; Herreros M; Hijona E; Jaúregui M; Laredo E; Martínez R; Mitxelena MJ; Montalvo I; Placer C; Portillo I; Sarasqueta C; Alarcón O; Alonso-Abreu I; Carrillo-Palau M; de la Vega-Prieto M; Díez-Fuentes ML; Gimeno-García A; González-Méndez Y; Hernández-Guerra M; Linertová R; Nicolás-Perez D; Reyes-Melián JM; Álvarez C; Augé JM; Balaguer F; Barau M; Bessa X; Bory F; Burón A; Castells X; Comas M; Cuatrecasas M; Estrada M; Ferrer O; Garrell I; Grau J; Guayta R; Hernández C; López-Cerón M; Macià F; Moreira L; Ocaña T; Pellisé M; Piracés M; Polbach S; Pozo À; Puigvehí M; Rodríguez C; Sala M; Seoane A; Serradesanferm A; Sivilla J; Trilla A; Belén Aguado M; Aldecoa S; Almazán R; Alonso A; Castro I; Cid E; Cid L; Clofent J; Luisa de Castro M; Estévez P; Fernández AB; Dolores González M; González S; González-Mao MC; Hernández V; Iglesias B

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Resumen

Background: The adenoma detection rate (ADR) is the main quality indicator of colonoscopy. The ADR recommended in fecal immunochemical testing (FIT)-based colorectal cancer screening programs is unknown. Methods: Using the COLONPREV (NCT00906997) study dataset, we performed a post-hoc analysis to determine if there was a correlation between the ADR in primary and work-up colonoscopy, and the equivalent figure to the minimal 20% ADR recommended. Colonoscopy was performed in 5722 individuals: 5059 as primary strategy and 663 after a positive FIT result (OC-Sensor™; cut-off level 15 µg/g of feces). We developed a predictive model based on a multivariable lineal regression analysis including confounding variables. Results: The median ADR was 31% (range, 14%–51%) in the colonoscopy group and 55% (range, 21%–83%) in the FIT group. There was a positive correlation in the ADR between primary and work-up colonoscopy (Pearson’s coefficient 0.716; p < 0.001). ADR in the FIT group was independently related to ADR in the colonoscopy group: regression coefficient for colonoscopy ADR, 0.71 (p = 0.009); sex, 0.09 (p = 0.09); age, 0.3 (p = 0.5); and region 0.00 (p = 0.9). The equivalent figure to the 20% ADR was 45% (95% confidence interval, 35%–56%). Conclusions: ADR in primary and work-up colonoscopy of a FIT-positive result are positively and significantly correlated.

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