Polyps are detected more often in early colonoscopies

Abstract

Objective

To examine the time variation in polyp detection for colonoscopies performed in a tertiary hospital and to explore independent factors that predict polyp detection rate (PDR).

Methods

Data on all patients who underwent colonoscopy for the diagnostic purpose at our endoscopy center in Zhongnan Hospital of Wuhan University from January 2021 to December 2021 were reviewed. The start time of included colonoscopies for eligible patients was recorded. PDR and polyps detected per colonoscopy (PPC) were calculated. The endoscopists’ schedules were classified into full-day and half-day shifts according to their participation in the morning and afternoon colonoscopies.

Results

Data on a total of 12116 colonoscopies were analyzed, with a PDR of 38.03% for all the patients and 46.38% for patients ≥50 years. PDR and PPC significantly decreased as the day progressed (both p < .001). For patients ≥50 years, PDR declined below 40% at 13:00–13:59 and 16:00–16:59. The PDR in the morning was higher than that in the afternoon for both half-day (p = .019) and full-day procedures (p < .001). In multivariate analysis, start time, patient gender, age, conscious sedation, and bowel preparation quality significantly predicted PDR (p < .001).

Conclusions

The polyp detection declined as the day progressed. A continuous work schedule resulted in a subpar PDR. Colonoscopies performed in the morning had a higher PDR than that in the afternoon. Patient gender, age, conscious sedation, and bowel preparation quality were identified as the independent predictors of PDR.

Keywords:

• Colonoscopy
• screening
• polyp detection rate
• quality indicator
• time factors

Disclosure statement

The authors, Zhang Zhang, Xiaojia Chen, Tingting Cao, Yumei Ning, Haizhou Wang, Fan Wang, Qiu Zhao, and Jun Fang, have no conflicts of interest or financial ties to disclose.

Additional information

Funding

This manuscript was funded by Wuhan University Zhongnan Hospital Difficult Disease Diagnosis and Treatment Capacity Improvement Project (oncology) [Grant No. ZLYNXM202017]. Hubei Province health and family planning scientific research project [Grant No. WJ2023M065]