P1612 - Differences in Colonoscopy Withdrawal Times and Adenoma Detection Rates Between Senior and Junior Endoscopists: A Retrospective Observational Study

Dalton A. Norwood, MD¹, Tatiana Torres Herman, MD², Rachel Taylor, MD², Udita Gupta, MD², Priya Nethala, MD³, Johnson Dane, MD², Douglas Morgan, MD, MPH², Fayez Sarkis, MD^2
1UAB Minority Health and Health Equity Research Center, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL; ²University of Alabama at Birmingham, Birmingham, AL; ³University of Alabama at Birmingham Hospital, Birmingham, AL

Introduction: Colonoscopy is the gold standard for detecting and preventing colorectal cancer. Two important quality indicators of colonoscopy are the adenoma detection rate (ADR), and the colonoscopy withdrawal time (CWT), a longer CWT is associated with higher ADR. Endoscopist experience is a potential factor that could influence both CWT and ADR, as more experienced endoscopists may be more efficient and thorough during the procedure. However, there is limited research comparing CWT and ADR between senior and junior endoscopists. The aim of this study is to compare CWT and ADR between senior and junior endoscopists at a single center over a 5-year period.

Methods: We performed a retrospective observational study includes patients who underwent colonoscopy by either senior or junior endoscopists at a single center over a 5-year period. We categorized endoscopist experience as junior if they have less than 5 years of experience or performed fewer than 500 colonoscopies, and senior if they have more than 5 years of experience or performed more than 500 colonoscopies. Comparison of CWT and ADR between senior and junior endoscopists was done using t-tests, or chi-square tests as appropriate, as well as subgroup analyses by colonoscopy indication. All statistical tests were two-sided with a significance level of 0.05. Data analysis was performed using STATA18.

Results: A total of 22542 consecutive colonoscopies were analyzed, 10164 and 12378 performed by Junior and Senior endoscopist respectively. 55.9% were females and median age was 57 years (IQR: 50-65). The median withdrawal time (IQR) was significantly longer for junior endoscopists (13.4 [13.3-13.5] minutes) than for senior endoscopists (8.8 [8.7-8.9] minutes) in the total population (MD:4.6, p< 0.001). This difference was observed across all indications for colonoscopy, including screening (MD: 4.7, p< 0.001), surveillance (MD: 5.7, p< 0.001) and diagnostic (MD: 3.3, p< 0.001). In terms of ADR, junior endoscopists had a significantly higher ADR than senior endoscopists for the total population (38.72% vs. 32.23%, p< 0.001), in both screening (42.2% vs. 32.95%, p< 0.001) and surveillance (51.37% vs. 41.54%, p< 0.001) indications. CWTs and ADRs per indication for diagnostic endoscopies can be found in table.

Discussion: Overall, these results suggest that junior endoscopists take longer to withdraw the colonoscope but have a higher ADR than senior endoscopists, with some variation across different indications.


Disclosures:


Dalton A. Norwood, MD¹, Tatiana Torres Herman, MD², Rachel Taylor, MD², Udita Gupta, MD², Priya Nethala, MD³, Johnson Dane, MD², Douglas Morgan, MD, MPH², Fayez Sarkis, MD². P1612 - Differences in Colonoscopy Withdrawal Times and Adenoma Detection Rates Between Senior and Junior Endoscopists: A Retrospective Observational Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.