A team from Dayton, Ohio, USA, retrospectively evaluated the miss rates of advanced adenomas on surveillance colonoscopy.
They reviewed 235 patients who had at least one repeat colonoscopy after initial polypectomy, between 1992 and 1999, at the Dayton Veterans Affairs Medical Center.
Here, closely supervised fellows conducted most colonoscopies.
Advanced adenomas were defined as polyps, 10 mm or greater in size, with or without a villous component or high-grade dysplasia.
Data of missed advanced adenomas in 122 patients who had complete colonoscopy with satisfactory preparation was reported. Data on the excluded patients was also noted.
The researchers discovered that 4 advanced adenomas (1 had intramucosal cancer) on second colonoscopy and 2 advanced adenomas on third colonoscopy were missed.
|Miss rate with complete colonoscopy:|
Second repeat: 2.5%
Third repeat: 3.3%
| American Journal of Gastroenterology |
The miss rate of advanced adenoma for all 232 patients was 1.7%.
For the 122 patients with complete colonoscopy and satisfactory colon preparation, the miss rate was 2.5% and 3.3% on second and third repeat colonoscopy, respectively.
No cancer was missed.
Dr Ihab Shehadeh, of the Department of Veterans Affairs Medical Center and Wright State University, Dayton, said on behalf of fellow authors, "The present study shows an advanced polyp miss rate that is comparable with other studies, even in a fellowship training setting."
"Prospective studies with tandem surveillance colonoscopy are needed to confirm our findings," it was concluded.