P4810 - From Monday Motivation to Friday Fatigue? A Retrospective Analysis of Colonoscopy Quality and Efficiency

William S. Haynes, ¹, Qiang Cai, MD, PhD, MACG²
1Louisiana State University Health Shreveport, Shreveport, LA; 2LSU Health Sciences Center - SHREVEPORT, LA, Shreveport, LA

Introduction: Several studies have examined differences between morning and afternoon colonoscopies. Early research showed that adenomas were more frequently detected in the morning compared to the afternoon. A later study reported that this difference in adenoma detection rate (ADR) between morning and afternoon procedures appeared to apply primarily to female patients. However, limited data exist on how the day of the week, particularly Monday versus Friday, affects colonoscopy performance. We hypothesized that procedures performed on Fridays would be shorter and have a lower ADR, potentially reflecting hastier technique or provider fatigue near the end of the clinical week.

Methods: We performed a retrospective chart review of 52 outpatient colonoscopies conducted at Ochsner LSU Health Shreveport between December 2024 and March 2025. We randomly selected 26 cases from Mondays and another 26 from Fridays. The average patient age was 56 on Mondays and 53 on Fridays. Gender distribution was equal on Mondays and predominantly female on Fridays (65.4%). Indications included screening (Mondays: 84.6%, Fridays: 69.2%), surveillance (11.5% for both), and diagnostic evaluation (Mondays: 3.8%, Fridays: 19.2%). ADR was defined as detection of ≥1 adenoma or sessile serrated lesion. Procedure duration, cecal withdrawal time, and room turnover time (interval from scope out of patient A to scope in for patient B) were recorded. Statistical analysis used two-sample t-tests and Fisher’s exact test, with p < 0.05 considered significant.

Results: ADR was higher on Mondays (57.7%) than Fridays (34.6%), but the difference was not statistically significant (p = 0.1637). Procedure duration was significantly longer on Mondays (mean = 21 min) than Fridays (15 min, p = 0.0246). Cecal withdrawal time was also significantly longer on Mondays (14 min 36 s) versus Fridays (10 min 37 s, p = 0.032). Turnover time did not differ significantly between Mondays (37 min) and Fridays (40 min, p = 0.6566).

Discussion: Colonoscopies performed on Fridays were significantly shorter in both total duration and cecal withdrawal time compared to Mondays, supporting the hypothesis of altered pacing at the end of the clinical week. While ADR was numerically lower on Fridays, the difference was not statistically significant. Turnover time did not significantly differ between weekdays. These findings suggest that procedural day may influence endoscopist behavior and warrant further study with a larger sample to evaluate the clinical implications.


Figure: Table 1: Patient Demographics and Colonoscopy Indications


Figure: Figure 1: ADR, Mondays vs. Fridays
Figure 2: Timing Metrics, Mondays vs. Fridays

Disclosures:
William Haynes indicated no relevant financial relationships.
Qiang Cai indicated no relevant financial relationships.

William S. Haynes, ¹, Qiang Cai, MD, PhD, MACG². P4810 - From Monday Motivation to Friday Fatigue? A Retrospective Analysis of Colonoscopy Quality and Efficiency, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.