Poster (15W158)

Four Eyes are Better than Two! Does Double- Observer Endoscopy Increase Polyp Detection Rate?

Author(s)

Karen Hartery, Orla Gildea, Marie Buckley, Gareth Horgan, Hugh Mulcahy, Juliette Sheridan, Garret Cullen, Glen Doherty

Department(s)/Institutions

Dept of Gastroenterology and Centre for Colorectal Disease, St. Vincent’s University Hospital, Dublin.

Introduction

Colonoscopy is regarded as an effective tool to reduce the incidence of colorectal cancer (CRC) and its associated mortality. The protection afforded by colonoscopy is thought to be due to detection and removal of adenomatous polyps. The adenoma detection rate (ADR) has been shown to inversely associated with the risks of interval colorectal cancer, advanced-stage interval cancer, and fatal interval cancer. Literature has shown that experienced endoscopy nurse as a second observer can increase polyp detection rate.

Aims/Background

To determine whether double-observer endoscopy (consultant and trainee) at time of training lists increased polyp detection rate.

Method

This study included out-patient colonoscopies performed from January 1st to July 31st, 2015. Patients were excluded if they were referred from National Bowel Screening Programme. Endoscopy data was extracted from EndoRad reporting system. Histology reports for polyp histology were obtained from PAS system. Data was analyzed using SPSS statistics program.

Results

A total of 1,266 outpatient colonoscopies were performed from January 1st to July 31st 2015 in St. Vincent’s University Hospital Endoscopy Unit excluding National Bowel Screening cases. In total 708 polyps, including 389 adenomas, were identified in 367 patients. 436 of these were performed for the indication surveillance. Overall PDR was 29%, with 32.6% in males and 25.7% in females. Overall ADR was 17.1% with 15% in males 19.2% in females. Multivariate analysis revealed male gender (OR 1.04, CI 95% 1.03- 1.04), older age at procedure (OR 1.4, CI 95% 1.09-1.8), surveillance as indication (OR 1.8, CI 95% 1.4-2.3), and procedure performed by both trainee and consultant were factors significantly associated with increased PDR (OR 1.6, CI 95% 1.19-2.2), (p<0.01). The PDR was significantly higher in the dual-observer group (Consultant and Trainee) at 37.2% (p= 0.001) versus singleobserver groups, (Consultant Only 26.8% and Trainee Only 27.2%).

Conclusions

We have shown that double-observer endoscopy, with a trainee doctor and consultant, is significantly associated with increased polyp detection rate.