Adenoma Detection Rate: the Primary Colonoscopy Quality Indicator

The mere mention of a colonoscopy can cause just about anyone to cringe. A visual examination of the rectum and colon? No thanks! But take a quick look at the statistics surrounding colon cancer and it becomes abundantly clear just how important a colonoscopy is:

  • Approximately 140,000 individuals are diagnosed with colon cancer each year in the United States.
  • Colon cancer claims the lives of more than 50,000 Americans annually.
  • Up to 60 percent of colorectal cancer deaths could be prevented if everyone over 50 had regular screenings (CDC).

There’s no denying that colonoscopies save lives, but experts say it isn’t just the test itself that matters; it’s the quality of the examination. That’s where adenoma detection rates come into play.

Adenoma detection rate (ADR) is a percentage that indicates how often a physician detects an adenoma during a colonoscopy in patients over 50. This figure is widely accepted as a benchmark of quality in colonoscopy screening and may be a key indicator in colon cancer incidence and survival outcomes.

Adenomas are small, benign tumors of glandular tissue that are detected and removed during a colonoscopy. Although adenomas themselves are not cancerous, they have the potential to become colon cancer if left undisturbed. A gastroenterologist with a high ADR is more likely to perform a thorough and quality examination that will detect the presence of any adenomatous polyps.

A report published in the New England Journal of Medicine (NEJM) found that patients who chose doctors with higher ADRs had a significantly lower risk of developing colon cancer. The rate of colon cancer among patients with doctors in the highest quintile of polyp detection was just 52 percent of that among patients with doctors in the lowest quintile. The study further found that every one percent increase in ADR was associated with a three percent decrease in colon cancer risk and five percent decrease in risk of fatal colon cancer.

When choosing a gastroenterologist to perform your colonoscopy, remember to ask the most important question of all: “What is your adenoma detection rate?” This rate should be at least 15 percent in women and 25 percent in men. While doctors are not currently required to record or share ADRs with their patients, a quality physician will be proud to share this information with you.

Another important question to ask is a physician’s average withdrawal time – the amount of time it takes to withdraw the scope from the colon. This figure represents how much time is spent examining the colon for polyps. You want your doctor’s average withdrawal time to be at least six minutes.

Talk to your gastroenterologist about ADRs and average withdrawal times, and make sure you’re getting the highest quality exam possible. When your long-term health is on the line, you can never be too careful.