The North Country Gastroenterology Experience 2022
“Five studies have established that gastroenterologists are more effective than surgeons and primary care physicians at preventing colorectal cancer by colonoscopy (CRC).” I According Corley published in the New England Journal of Medicine, there is a 3 percent reduction in colorectal cancer incidence and a 5 percent reduction in cancer mortality for each 1 percent increase in adenoma detection rate.
Colonoscopy is the most effective procedure for finding adenomatous polyps if the adenoma detection rate is high enough; according to the studies adenomas should be detected at least 25% of the time.
In 2022 we have had an adenoma detection rate of 57%. For the last 9 years our adenoma detection rate is 48%.
North Country Gastroenterology participates in a Nation Wide registry, in comparison NCG adenoma detection rate is 9.5% higher than the Nation Wide registry.
According to the recent studies, inadequate preparation should not occur in more than 15% of colonoscopies.
Patients at North Country Gastroenterology (NCG) have an inadequate prep rate of only 4.3%.
Cecal intubation should happen in at least 90% of colonoscopies and photographic documentation in 95%.
At NCG we reach cecal intubation in 100% of colonoscopies and every patient goes home with photographs of our findings.
Perforation should occur in less than 1/1000 for screening procedures and 1/500 for all other exams.
Out of a total of 16,149 cases, we have only had 2 perforations; both with polyp removal and none for screening purposes.
Withdrawal time of the colonoscopy should be greater than or equal to 6 mins.
100% of completed colonoscopies done at NCG take greater than 6 minutes to withdraw. The average withdrawal time at NCG is more than 10 minutes.
Sessile polyps less than 2 cm should be removed endoscopically in more than 90% of cases.
100% of those polyps have been removed at the time of endoscopy here at NCG.
A second look in the colon via forward view or retroflex view should be done in the majority of screening cases, as this can increase adenoma detection rates thus decreasing colorectal cancer.
100% of colonoscopies performed include a second look at the ascending colon and cecum.
I. Rex, Douglas K. MD, Schoenfeld, Philip S. MD, MSEd, MSc (Epi), Cohen, Jonathan MD, Pike, Irving M. MD, Adler, Douglas G. MD, Fennerty, M. Brian MD, Lieb II, John G. MD, Park, Walter G. MD, Rizk, Maged K. MD, Sawhney, Mandeep S. MD, MS, Shaheen, Nicholas J. MD, MPH, Wani, Sachin MD, and Weinberg, David S. MD, MSc. (2014). Quality Indicators for Colonoscopy. The American Journal of Gastroenterology, 110: 72-90. Doi 10.1038/ajg.2014.385