Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies

Douglas Rex, C. S. Cutler, G. T. Lemmel, E. Y. Rahmani, D. W. Clark, Debra Helper, Glen Lehman, D. G. Mark

Research output: Contribution to journalArticle

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Abstract

Background and Aims: The miss rate of colonoscopy for neoplasms is poorly understood. The aim of this study was to determine the miss rate of colonoscopy by same day back-to-back colonoscopy. Methods: Two consecutive same day colonoscopies were performed in 183 patients. The patients were randomized to undergo the second colonoscopy by the same or a different endoscopist and in the same or different position. Results: The overall miss rate for adenomas was 24%, 27% for adenomas ≤5 mm, 13% for adenomas 6-9 mm, and 6% for adenomas ≤1 cm. Patients with two or more adenomas at the first examination were more likely than patients with no or one adenoma detected at the first examination to have one or more adenomas at the second examination (odds ratio, 3.3; 95% confidence interval, 1.69-6.46). Right colon adenomas were missed more often (27%) than left colon adenomas (21%), but the difference was not significant. There was evidence of variation in sensitivity between endoscopists, but significant miss rates for small adenomas were found among essentially all endoscopists. Conclusions: Using current colonoscopic technology, there are significant miss rates for adenomas <1 cm even with meticulous colonoscopy. Miss rates are low for adenomas ≤1 cm. The results suggest the need for improvements in colonoscopic technology.

Original languageEnglish
Pages (from-to)24-28
Number of pages5
JournalGastroenterology
Volume112
Issue number1
StatePublished - 1997

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Colonoscopy
Adenoma
Colon
Technology
Odds Ratio
Confidence Intervals

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Rex, D., Cutler, C. S., Lemmel, G. T., Rahmani, E. Y., Clark, D. W., Helper, D., ... Mark, D. G. (1997). Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. Gastroenterology, 112(1), 24-28.

Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. / Rex, Douglas; Cutler, C. S.; Lemmel, G. T.; Rahmani, E. Y.; Clark, D. W.; Helper, Debra; Lehman, Glen; Mark, D. G.

In: Gastroenterology, Vol. 112, No. 1, 1997, p. 24-28.

Research output: Contribution to journalArticle

Rex, D, Cutler, CS, Lemmel, GT, Rahmani, EY, Clark, DW, Helper, D, Lehman, G & Mark, DG 1997, 'Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies', Gastroenterology, vol. 112, no. 1, pp. 24-28.
Rex D, Cutler CS, Lemmel GT, Rahmani EY, Clark DW, Helper D et al. Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. Gastroenterology. 1997;112(1):24-28.
Rex, Douglas ; Cutler, C. S. ; Lemmel, G. T. ; Rahmani, E. Y. ; Clark, D. W. ; Helper, Debra ; Lehman, Glen ; Mark, D. G. / Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. In: Gastroenterology. 1997 ; Vol. 112, No. 1. pp. 24-28.
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