Astin Worden, MD1, Carolyn Mead-Harvey, MS2, Lisa Anderson, MSN2, Francisco C.. Ramirez, MD, MACG2, Suryakanth Gurudu, MD2 1Mayo Clinic, Phoenix, AZ; 2Mayo Clinic, Scottsdale, AZ Introduction: Colonoscopy is the gold standard in colon cancer screening and has been shown to reduce the incidence of colorectal cancer (CRC) and its associated mortality. A high-quality exam is essential in procedural efficacy and patient outcomes. An update in colonoscopy quality metrics was proposed in the Fall of 2024 to include a higher adenoma detection rate ( > 35%) and longer withdrawal time ( > 8 minutes). This study aims to evaluate how the endoscopists in our center perform against these new benchmarks. Methods: This is a single center retrospective review including 7098 colonoscopies performed by 51 endoscopists in 1/2024-12/2024. Key metrics including cecal intubation rate (CIR), withdrawal time (WT), adenoma detection rate (ADR), and sessile serrated lesion detection rate (SSLDR) were reported. Patients with inadequate preparation were excluded. The proportion of endoscopists meeting previous quality benchmarks was compared to those meeting updated thresholds. Results: All physicians achieved cecal intubation in ≥95% of their cases. For WT, 45/51 (88%) physicians had WT >6 minutes and 35/51 (69%) physicians had WT >8 minutes in ≥95% of their cases. When assessing WT in 100% of their cases, 32/51 (63%) had a WT >6minutes and 17/51 (33%) had a WT >8 minutes (Figure 1). Regarding adenoma detection, 49/51 (96%) physicians had ADR ≥25% and 47/51 (92%) physicians had ADR ≥35% (Figure 2). Furthermore, 44/51 (86%) physicians had SSLDR ≥6%. Discussion: Colonoscopy quality was excellent in this review, likely due to the existing quality monitoring and feedback program at our center. While a high proportion of our endoscopists met the new thresholds for ADR and SSLDR, adoption of a longer WT is an area for improvement. Notably our study period overlapped with the prior guidelines recommending >6 minute WT, which may account for the observed low adherence to >8 minute WT threshold. Adequate WT allows for close mucosal inspection and can contribute to higher ADR and SSLDR. Ongoing monitoring of these updated quality indicators is crucial for improving colonoscopy quality and ultimately enhancing CRC prevention.
Figure: Figure 1: Proportion of adequate withdrawal time for each endoscopist with the top panel representing the old threshold of 6 minutes and the bottom panel representing the new threshold of 8 minutes
Figure: Figure 2: Adenoma detection rate for each endoscopist ordered by ascending proportion. The previous ADR threshold of 25% is represented by the yellow dotted line, and new threshold of 35% is represented by the red dotted line.
Disclosures: Astin Worden indicated no relevant financial relationships. Carolyn Mead-Harvey indicated no relevant financial relationships. Lisa Anderson indicated no relevant financial relationships. Francisco Ramirez indicated no relevant financial relationships. Suryakanth Gurudu indicated no relevant financial relationships.
Astin Worden, MD1, Carolyn Mead-Harvey, MS2, Lisa Anderson, MSN2, Francisco C.. Ramirez, MD, MACG2, Suryakanth Gurudu, MD2. P0491 - Assessing Endoscopist Performance Using Updated Colonoscopy Quality Benchmarks, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
