Gastroenterologist focus of clinical practice affects adenoma detection in screening colonoscopy

Hadie Razjouyan, Myunghoon Kim, John Levenick, Kofi Clarke, Thomas McGarrity

Research output: Contribution to journalArticlepeer-review


Our objective was to determine whether the clinical focus of gastroenterology practice would affect screening colonoscopy quality metrics, specifically adenoma detection (AD). In a retrospective study of screening colonoscopies, gastroenterologists were categorized based on their clinical subspecialty focus into general/motility, hepatology, inflammatory bowel disease (IBD), and interventional endoscopy. The primary outcome was AD with a secondary outcome of adenoma and/or sessile serrated polyp (SSP) detection (AD+SSP). A total of 5271 (male: 49.1%) complete colonoscopies were performed between 2010 and 2020 by 16 gastroenterologists (male: 62.5%, general/motility specialists: 3, hepatologists: 3, IBD specialists: 4, interventional endoscopists: 6). The AD and AD+SSP rate between each specialty focus were 27.5% and 31.0% for general/motility, 31.4% and 35.5% for hepatology, 38.4% and 43.6% for IBD, and 37.5% and 43.2% for interventional endoscopy. In regression analysis, patient's male gender (odds ratios [OR]: 1.81, 95% CI: 1.60-2.05, P<.001), longer withdrawal time (OR: 1.16, 95% CI: 1.14-1.18, P<.001), hepatologist (OR: 1.25, 95% CI: 1.02-1.53, P=.029), IBD subspecialist (OR: 1.60, 95% CI: 1.30-1.98, P<.001), and interventional endoscopist (OR: 1.36, 95% CI: 1.13-1.64, P<.001) were independently associated with AD. Moreover, patient's male gender (OR: 1.64, 95% CI: 1.45-1.85, P<.001), acceptable bowel preparation (OR: 1.29, 95% CI: 1.06-1.56, P=.010), withdrawal time (1.20, 95% CI: 1.18-1.22, P<.001), hepatologist (OR: 1.30, 95% CI: 1.07-1.59, P=.008), IBD subspecialist (OR: 1.72, 95% CI: 1.39-2.12, P<.001), interventional endoscopist (OR: 1.44, 95% CI: 1.20-1.72, P<.001) were independent factors that improved detection of AD+SSP. Subspecialty focus of practice was an important factor in AD rate along with the male gender of the patient, bowel preparation, and withdrawal time.

Original languageEnglish (US)
Pages (from-to)E33818
JournalMedicine (United States)
Issue number20
StatePublished - May 19 2023

All Science Journal Classification (ASJC) codes

  • General Medicine


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