“natural Intelligence”: Investigation of the Adenoma Detection Rate in Colonoscopy With the Presence of a Trainee Assistant
Year: 2024
Type: article
Study design: Observational Study
Abstract: Globally, colorectal cancer (CRC) is the third most common cancer in the world, responsible for approximately 10% of all cancer cases and is the second leading cause of cancer-related deaths worldwide. In Brazil, it is estimated that there will be 45,000 new cases annually between 2023 and 2025. The well-known adenoma-carcinoma sequence and advancements in CRC research are related to reduced mortality, early detection, and high cure rates. Colonoscopy is crucial in the prevention and screening of CRC, and the adenoma detection rate (ADR) is the main quality indicator for the exam. The exponential increase in technology, improving the images in endoscopic exams, is a reality and has contributed to CRC prevention. The recommended ADR by the American Society of Gastroenterology is ≥30% in men and ≥20% in women. Several factors are associated with an increased ADR, such as the use of artificial intelligence, chromoscopy, the time spent withdrawing the device, the quality of bowel preparation, and the use of antispasmodics. Studies have shown that the presence of an attentive assistant during the exam is also an important factor for a higher ADR. The present study aims to assess the impact of a trainee assistant on the adenoma detection rate in a public hospital in Juiz de Fora. Method Evaluation of colonoscopy reports performed between March and December 2023 in a public hospital by a team of colorectal specialists. Data was collected regarding sex, age, hospitalization at the time of the exam, adenoma detection rate, bowel preparation quality, and organized in an Excel spreadsheet. Results 104 colonoscopy reports were evaluated, with 38 being performed only by an experienced colorectal specialist (Group 1) and 66 performed by this specialist along with a specialist in training (Group 2). The ADR in Group 1 was 34%, while in Group 2 it was 45%. When compared to exams performed on non-hospitalized (asymptomatic) patients, the ADR was 28% and 50% in Groups 1 and 2, respectively. Conclusion The ADR is an important parameter in the quality of colonoscopy, and it has been increasing alongside the growth of technologies and techniques implemented in large centers. A cost-effective method to increase ADR is the routine use of a second observer during exams. Publication History Article published online: 25 April 2025 © 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/) Thieme Revinter Publicações Ltda. Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
Source: Journal of Coloproctology
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4409791945