Korean J Gastroenterol.  2014 Jan;63(1):11-17. 10.4166/kjg.2014.63.1.11.

Usefulness of Polyp and Adenoma Detection Rate in the Proximal and Distal Colon

• Choi SY
• Park DI
• Lee CK
• Cha JM
• Lee SH
• Whangbo Y
• Eun CS
• Han DS
• Lee BI
• Shin JE

• KMID: 1711300
• DOI: http://doi.org/10.4166/kjg.2014.63.1.11

Abstract

BACKGROUND/AIMS
The polyp detection rate (PDR) has been suggested as a surrogate for adenoma detection rate (ADR). The purpose of this study was to determine the level of agreement between PDR and ADR in the proximal and distal colon.
METHODS
A total of 1,937 consecutive, asymptomatic individuals aged 40 years and older who underwent colonoscopies at six academic teaching hospitals in Korea were included in this study. PDR and ADR were calculated for each colonic segment. PDR was compared with ADR in the proximal and distal colon.
RESULTS
During 1,937 colonoscopies, 1,862 polyps were removed; 1,421 (76%) were adenomas. The PDR and ADR in the proximal colon was 25.8% and 22.8%, respectively (kappa value=0.917, p=0.26), and that in the distal colon was 28.9% and 22.2%, respectively (p<0.001). There was a strong correlation between PDR and ADR in the proximal colon, but diverged in sigmoid colon and rectum.
CONCLUSIONS
PDR and ADR correlate well in the proximal colon, but not in the distal colon, especially sigmoid and rectum. PDR should be measured for each colonic segment when using PDR as a surrogate for ADR. PDR is a valid proxy for ADR in the proximal colon.

Keyword

Colonoscopy; Colonic neoplasms

MeSH Terms

Adenoma/*diagnosis/epidemiology
Adult
Aged
Aged, 80 and over
Colon/pathology
Colonic Neoplasms/*diagnosis/epidemiology
Colonic Polyps/*pathology
Colonoscopy
Female
Hospitals, University
Humans
Incidence
Male
Middle Aged
Retrospective Studies

Figure

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  Fig. 1. Distribution of adenomas and polyps by colon segment.

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  Fig. 2. Polyp detection rate (PDR) and adenoma detection rate (ADR) by colon segment. The PDR and ADR in the proximal colon was 25.8% and 22.8%, respectively (kappa value [K]=0.917, p=0.26), and that in the distal colon was 28.9% and 22.2%, respectively (p＜0.001).

• 

  Fig. 3. (A) Polyp detection rate (PDR) and adenoma detection rate (ADR) by colon segment in men. The PDR and ADR in the proximal colon was 31.6% and 28.3%, respectively (kappa value [K]=0.916, p=0.077), and that in the distal colon was 34.4% and 26.4%, respectively (p＜0.001).(B) PDR and ADR by colon segment in women. The PDR and ADR in the proximal colon was 18.5% and 16.1%, respectively (kappa value=0.915, p=0.161), and that in the distal colon was 22.2% and 16.9%, respectively (p=0.004).

Reference

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