By Jayde Kurland M.D. FACG, AGAF, FACP.
Adenomas of the colon (large intestine) are a type of polyp that if not removed at an early stage can become cancerous. When planning for your colonoscopy, it’s important to be cautious in your search for a Gastroenterologist (GI) doctor. Some doctors find more polyps than others – and that translates into greater protection from cancer for their patients, so it’s important to select one who provides a minimum percentage of adenomas (a specific type of polyp).
What is a colonoscopy?
A colonoscopy is a procedure that uses a thin, flexible instrument called a colonoscope to examine the lining of your colon (large intestine). A very small video camera is attached to the end of the colonoscope, providing direct examination of the lining where polyps and cancers develop.
This procedure is usually performed in order to screen for colon cancer and to diagnose the cause of rectal bleeding. It typically detects and allows for treatment of precancerous growths.
What is the adenoma detection rate (ADR)?
The effectiveness of a screening colonoscopy is crucial and can help with prevention and early detection of colon cancer.
The ADR represents the proportion of people undergoing a screening colonoscopy who have one or more adenomas detected. The recommended ADR target for a quality screening colonoscopy is now at least 25% in women and men.
A doctor’s ability to detect an adenoma – the most common type of polyp and the most common precursor of colon cancer – has been linked to the likelihood of the patient later developing colon cancer. The better the doctor is at detecting and removing precancerous growths, the lower their patient’s risk of developing colon cancer.
Any top Gastroenterologist should have an ADR greater than 25%. This number is now tracked in order to assure that quality examinations are being performed. ADR is a quality measure now being tracked by Medicare and commercial payers.
No single colonoscopy is guaranteed to have perfect polyp detection. But if a patient has only one polyp and it is not found during their screening colonoscopy, that patient is considered to not have polyps. Under normal recommendations, he or she would not have to return for their next colonoscopy for 10 years.
Even a small increase in ADR can have a significant impact. For every 1% increase in ADR over the target polyp detection rate, a patient’s risk of colon cancer falls by three times that or 3%, and their risk of death from colon cancer falls by 5%. Those doctors with high ADRs are providing their patients a higher degree of protection from cancer than an “average colonoscopy” in some cases up to 40%.
When should I undergo a colonoscopy?
For the most part, patients begin with screening colonoscopies at the age of 50. However, there are some relevant factors that could prompt a doctor to recommend a colonoscopy at an earlier age. These include:
Having a family history of colon cancer
Having a family history of adenomatous polyps
Having a history of inflammatory bowel disease, including ulcerative colitis and Crohn’s disease
Having a history of smoking
Having type 2 diabetes
Being overweight or obese
It should be remembered that if you have bleeding you should not wait for a “screening” examination.
Where can I see a Gastroenterologist with a high adenoma detection rate in Lima?
Every doctor in Gastrointestinal Associates of Lima and the Endoscopy Center of West Central Ohio has an adenoma detection rate which exceeds the 25% benchmark. It is important to note that the previous adenoma detection rate minimum was 15%.
We perform colon cancer screenings at the Endoscopy Center of West Central Ohio, a state-of-the-art facility.
Quality differs among colonoscopists from different specialties other than GI as well. Make sure to ask your doctor what their ADR is?