Adenoma Detection Rates for Screening Colonoscopies in Smokers and Obese Adults: Data From the New Hampshire Colonoscopy Registry.
Adenoma Detection Rates for Screening Colonoscopies in Smokers and Obese Adults: Data From the New Hampshire Colonoscopy Registry.
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DOI：
10.1097/mcg.0000000000000795
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发表时间：
2017
影响因子：
2.9
通讯作者：
Butterly LF
中科院分区：
文献类型：
--
作者：
Anderson JC;Weiss JE;Robinson CM;Butterly LF
在新罕布什尔结肠镜检查登记处检查吸烟者和肥胖成人的筛查腺瘤检出率（ADR）和齿状检出率（SDR）。不良反应是筛查结肠镜检查的一项质量指标，与预防间隔期结直肠癌（CRC）有关。目前，只有针对性别的ADR基准报告。然而，正如2009年美国胃肠学会CRC筛查指南所强调的那样，肥胖和吸烟≥20包年是结直肠癌的有力预测因素。比较吸烟者和肥胖成年人的不良反应与没有这些风险的人的数据有限。我们计算了≥50岁参与者结肠镜筛查的ADR、SDR和95%置信区间。通过吸烟暴露（从不吸烟vs < 20包年vs≥20包年）和体重指数（BMI < 30 vs BMI≥30）比较性别和性别年龄特异性比率。2009年4月至2013年9月，共在20家医院由77名内镜医师进行了21,539例结肠镜筛查。≥20包年的非吸烟者和吸烟者之间的不良反应差异为8.8% (p<0.0001)，肥胖组之间的不良反应差异为5.0% （p<0.0001）。在吸烟者和肥胖参与者中，ADR和SDR的性别特异性和性别年龄特异性显著增加。吸烟者和肥胖成年人的ADR和SDR明显高于没有这些风险的同龄人。内窥镜医师在将其比率与既定基准进行比较时，应考虑这些风险在筛查人群中的流行程度。基于吸烟和肥胖计算性别或性别年龄特异性不良反应和特别提款权可能为吸烟者和肥胖成年人患病率特别高的人群提供最佳保护。
To examine screening adenoma detection rates (ADR) and serrated detection rates (SDR) among smokers and obese adults in the New Hampshire Colonoscopy Registry. ADR, a quality measure for screening colonoscopies, is associated with protection from interval colorectal cancer (CRC). Currently, only sex-specific ADR benchmarks are reported. However, obesity and smoking ≥ 20 pack-years are strong predictors for colorectal neoplasia, as highlighted by the 2009 American College of Gastroenterology CRC Screening Guidelines. Data comparing ADR in smokers and obese adults to those without these risks are limited. We calculated ADR, SDR and 95% confidence intervals for screening colonoscopies in participants ≥ 50 years. Sex and sex-age specific rates were compared by smoking exposure (never versus < 20 pack-years versus ≥ 20 pack-years) and body mass index (BMI < 30 versus BMI ≥ 30). 21,539 screening colonoscopies were performed by 77 endoscopists at 20 facilities (4/2009 -9/2013). The difference in ADR between non-smokers and smokers with ≥ 20 pack-years was 8.8% (p < 0.0001) and between obesity groups 5.0% (p<0.0001). Significant sex specific and sex-age specific increases in ADR and SDR were found among smokers and obese participants. ADR and SDR for smokers and obese adults were significantly higher than their counterparts without those risks. Endoscopists should consider the prevalence of these risks within their screening population when comparing their rates to established benchmarks. Calculating sex or sex-age specific ADR and SDR based on smoking and obesity may provide optimal protection for populations with a particularly high prevalence of smokers and obese adults.