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Barret M, Boustiere C, Canard JM, Arpurt JP, Bernardini D, Bulois P, Chaussade S, Heresbach D, Joly I, Lapuelle J, Laugier R, Lesur G, Pienkowski P, Ponchon T, Pujol B, Richard-Molard B, Robaszkiewicz M, Systchenko R, Abbas F, Schott-Pethelaz AM, Cellier C. Factors associated with adenoma detection rate and diagnosis of polyps and colorectal cancer during colonoscopy in France: results of a prospective, nationwide survey. PLoS One 2013; 8:e68947. [PMID: 23874822 PMCID: PMC3715530 DOI: 10.1371/journal.pone.0068947] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 06/04/2013] [Indexed: 02/06/2023] Open
Abstract
Introduction Colonoscopy can prevent deaths due to colorectal cancer (CRC) through early diagnosis or resection of colonic adenomas. We conducted a prospective, nationwide study on colonoscopy practice in France. Methods An online questionnaire was administered to 2,600 French gastroenterologists. Data from all consecutive colonoscopies performed during one week were collected. A statistical extrapolation of the results to a whole year was performed, and factors potentially associated with the adenoma detection rate (ADR) or the diagnosis of polyps or cancer were assessed. Results A total of 342 gastroenterologists, representative of the overall population of French gastroenterologists, provided data on 3,266 colonoscopies, corresponding to 1,200,529 (95% CI: 1,125,936-1,275,122) procedures for the year 2011. The indication for colonoscopy was CRC screening and digestive symptoms in 49.6% and 38.9% of cases, respectively. Polypectomy was performed in 35.5% of cases. The ADR and prevalence of CRC were 17.7% and 2.9%, respectively. The main factors associated with a high ADR were male gender (p=0.0001), age over 50 (p=0.0001), personal or family history of CRC or colorectal polyps (p<0.0001 and p<0.0001, respectively), and positive fecal occult blood test (p=0.0005). The prevalence of CRC was three times higher in patients with their first colonoscopy (4.2% vs. 1.4%; p<0.0001). Conclusions For the first time in France, we report nationwide prospective data on colonoscopy practice, including histological results. We found an average ADR of 17.7%, and observed reduced CRC incidence in patients with previous colonoscopy.
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Affiliation(s)
- Maximilien Barret
- Department of Gastroenterology and Digestive Endoscopy, George Pompidou European Hospital and Faculté Paris Descartes, Paris, France
| | | | - Jean-Marc Canard
- Department of Gastroenterology and Digestive Endoscopy, George Pompidou European Hospital and Faculté Paris Descartes, Paris, France
| | | | - David Bernardini
- Department of Gastroenterology, Toulon Font Pré Hospital, Toulon, France
| | - Philippe Bulois
- Department of Gastroenterology, Huriez Hospital, Lille, France
| | | | - Denis Heresbach
- Department of Gastroenterology, Cannes Hospital, Cannes, France
| | - Isabelle Joly
- Department of Gastroenterology, Saint-Brieuc Private Hospital, Saint Brieuc, France
| | - Jean Lapuelle
- Department of Gastroenterology, Saint Jean Languedoc Private Hospital, Toulouse, France
| | - René Laugier
- Department of Gastroenterology, La Timone Hospital, Marseille, France
| | - Gilles Lesur
- Department of Gastroenterology, Ambroise Paré Hospital, Boulogne, France
| | - Patrice Pienkowski
- Department of Gastroenterology, Le Pont de Chaume Private Hospital, Montauban, France
| | - Thierry Ponchon
- Department of Gastroenterology, Edouard Herriot Hospital, Lyon, France
| | - Bertrand Pujol
- Department of Gastroenterology, Jean Mermoz Private Hospital, Lyon, France
| | | | - Michel Robaszkiewicz
- Department of Gastroenterology, La Cavale Blanche University Hospital, Brest, France
| | | | - Fatima Abbas
- Pôle information médicale évaluation recherche, Université Claude Bernard-Lyon 1, Lyon, France
| | | | - Christophe Cellier
- Department of Gastroenterology and Digestive Endoscopy, George Pompidou European Hospital and Faculté Paris Descartes, Paris, France
- * E-mail:
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