Adenoma Detection Rates for Rural Surgeons

Abstract

Background

Colorectal cancer is the second leading cause of cancer-related death in the United States, with increasing incidence of new cases in the past few years. Routine screening via colonoscopies is a fundamental aspect of prevention and early detection. Rural patients face greater barriers to accessing colonoscopies given the low penetrance of gastroenterologists in rural counties. Therefore, rural general surgeons are needed to perform colonoscopies to meet the demands of their patient population. In this study, we aim to examine the adenoma detection rates (ADR) for general and colorectal surgeons in a rural setting.

Materials and Methods

Using electronic health record data, we analyzed procedure and pathology results for screening and surveillance colonoscopies performed at a single practice in rural Oregon from January 2020 through June 2024.

Results

A total of 4264 screening and 3663 surveillance colonoscopies were performed over the study period by 4 surgeons (1 colorectal, 3 general). For male patients, the screening ADR was 54% and the surveillance ADR was 62%. For female patients, the screening ADR was 41% and the surveillance ADR was 50%. For all patients, the colorectal surgeon had a screening ADR of 50% and surveillance ADR of 59%, and the general surgeons had screening ADRs ranging between 40 and 50% and surveillance ADRs between 50 and 56%. All surgeons had ADRs well-above the national benchmarks for male, female, and overall populations.

Discussion

Our analysis suggests that rural general surgeons can perform high quality colonoscopies, with ADRs well-above national benchmarks and consistent with those of gastroenterologists.