Surveillance colonoscopy in inflammatory bowel disease (IBD) is advocated for early diagnosis of neoplasia but is imperfect because some patients develop cancer despite surveillance.
Dr Toruner and colleagues determined if any endoscopic factors during surveillance colonoscopy were associated with the diagnosis of colorectal dysplasia before the development of cancer.
The team reviewed the Mayo Clinic endoscopic database and medical records of patients with IBD who underwent surveillance colonoscopy between 2002 and 2003.
The researchers sought associations between endoscopic factors and the diagnosis of dysplasia.
|Every additional minute in colonoscopy time increased the dysplasia diagnosis rate by 4 %|
|Inflammatory Bowel Diseases|
Among 635 IBD patients, 24 had flat dysplasia, 12 had IBD-related polypoid dysplasia and 28 had sporadic tubular adenoma.
The team noted that colonoscopies, in which flat dysplasia was identified, varied in median duration 25 min compared with 22 min for those in which dysplasia was not found.
Using logistic regression analysis, the investigators found that every additional minute in total colonoscopy time increased the flat dysplasia diagnosis rate by 4 %.
The research team observed a significant correlation between median surveillance colonoscopy duration per endoscopist and flat dysplasia diagnosis rate.
The team reported that the number of biopsies taken during the procedures with flat dysplasia ranged from a median of 28 compared with 25 in those without flat dysplasia.
There was no significant effect of biopsy number on dysplasia diagnosis.
Dr Toruner concludes, “Our results show that the practice of surveillance colonoscopy varies greatly among endoscopists.”
“Longer procedure duration is significantly associated with the likelihood of dysplasia diagnosis.”