How Good is Your Doctor?

Colorectal cancer screeners can tell patients their ADR

(RxWiki News) As a patient, you have a right to know how good your doctor is. And you should know. The answer to one question may just save your life.

The purpose of a colonoscopy is to detect polyps or tumors that could signal a high risk for or the presence of colorectal cancer. One hard-to-detect polyp is called an adenoma.

A doctor at the Mayo Clinic suggests that all colonoscopy patients should ask their doctor how good they are at detecting adenoma. This is called the adenoma detection rate, or ADR. Hint – it should be 20 percent or higher.

"Ask your doctor about ADR."

A team of Mayo Clinic physicians and researchers has long been working to help people who perform colonoscopies (endoscopists) detect polyps better. The team has been led by Michael Wallace, MD, MPH, chair of the Division of Gastroenterology and Hepatology at Mayo Clinic in Florida.

"Numerous studies have shown that increased detection and removal of potentially precancerous polyps lowers the incidence of colorectal cancer," Dr. Wallace said in a statement.

Unlike other polyps that protrude from the colon or rectum, adenomas are flat. That’s why they’re so easy to miss. But these lesions can be the most dangerous – indicating a very high risk for full-blown colorectal cancer.

The team developed a two-hour course to describe and show all types of polyps, including the flat adenoma lesions. Seven endoscopists were randomly selected to take the course. Some 2,400 colonoscopies were performed during the study period.

To learn how effective this training was, the researchers measured the results of all 15 endoscopists from Mayo, whose beginning average ADR was 35, about twice the national average of 20 – meaning one in five adenomas was detected.

The endoscopists who took the course improved their ADR by 47 percent, while their colleagues’ scores remained 35.

Dr. Wallace said this study proved that the proficiency of already skilled endoscopists can be substantially improved with this “relatively simple education program.”

Plans are underway to test the effectiveness of this program among a larger range of community-based physicians, who are the doctors who perform most of the colonoscopies.

Findings from this study, which was funded by the Mayo Clinic, were published January 8 in the American Journal of Gastroenterology.

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Review Date: 
January 9, 2013