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Background: The adenoma detection rate (ADR) is a quality indicator for colonoscopy. High definition (HD) imaging has been reported to increase polyp detection rates.
Objective: The primary objective of this study was to compare polyp detection rate (PDR) and adenoma detection rate (ADR) before and after the implementation of HD colonoscopy.
Methods: A retrospective chart review was performed on two groups of patients aged 48-55 years old, who underwent first time screening colonoscopy. The first group had their screening with standard definition (SD) colonoscopy in the first 6 months of 2011. The second group had their screening with HD colonoscopy during the first six months of 2012. We compared age, gender, PDR, ADR, average size of adenomatous polyps. Statistical analysis was performed with Fischer's Exact Test and Pearson Chi-Square.
Results: 1268 patients were involved in the study (634 in each group). PDR (35.3% vs 45%, p < 0.001) and ADR (19.1% vs 25.4%, p= 0.007) were higher in the HD group. The average size of adenomatous polyp were the same in two groups (0.57 vs 0.55, p=0.63). When polyps were categorized into size groups there was no difference in ADR between the two timeframes (< 5mm in size ( 45.5% vs 41%), 5-10mm ( 46.6% vs 56%) and > 10mm (7.7% vs 2.6%), p=0.15). Polyps were most commonly seen in sigmoid (30.6% vs 30.4%). Multiple polyps (25.6% vs 29%, p=0.51) were more detected in the HD group.
Conclusion: Screening colonoscopy with high definition technology significantly improved both PDR and ADR. The clinical significance of these findings is unclear but could be justified if findings result in reduction of interval colon cancer rates.