Again, No Need To Adjust Adenoma Detection Rate After Inclusion of 45- To 49-Year-Olds

This study looked at a large health care system’s first-time screening colonoscopies from the period October 2017 through December 2018, prior to the American Cancer Society inclusion of 45- to 49-year-olds in its screening recommendation, compared with screening colonoscopies performed from January 2019 through August 2021, after the release of the new recommendation.

The proportion of first-time screening colonoscopies performed in 45- to 49-year-olds increased from 3.5% in the first period to 11.6% in the second period. The overall adenoma detection rate (ADR) among 45- to 79-year-old patients increased from 35.1% to 42.6%, and the ADR in 45- to 49-year-old patients increased from 22% to 34.3%, suggesting the impact of a quality program that was only recently fully instituted. During the second period, the ADR, advanced-ADR, sessile serrated lesion (SSL) detection rate, advanced-SSL detection rate, and adenomas per colonoscopy in the 45- to 49-year-olds were similar (34.3%, 6.3%, 8.6%, 2.9%, and 0.58, respectively) to those in 50- to 54-year-olds (38.2%, 5.8%, 9.4%, 3.0%, and 0.63) and also very similar to those in 60- to 64-year-olds who underwent rescreening colonoscopy (33.4%, 6.1%, 7.2%, 2.3%, and 0.61).