Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr;66(4):1168-1174.
doi: 10.1007/s10620-020-06321-3. Epub 2020 May 18.

Longer Withdrawal Time Is More Important than Excellent Bowel Preparation in Colonoscopy of Adequate Bowel Preparation

Ji Min Choi  1 , Ji Yeon Seo  2 , Jooyoung Lee  1 , Yoo Min Han  1 , Eun Hyo Jin  1 , Jung Ho Bae  1 , Joo Hyun Lim  1
Affiliations

Longer Withdrawal Time Is More Important than Excellent Bowel Preparation in Colonoscopy of Adequate Bowel Preparation

Ji Min Choi et al. Dig Dis Sci. 2021 Apr.

Abstract

Background: Adequate bowel preparation is crucial for effective screening colonoscopy. However, it is unclear whether higher bowel preparation scores correspond to beneficial effects on the adenoma and polyp detection rate (ADR and PDR) in the adequate bowel preparation group.

Aims: This study aimed to evaluate the effects of bowel preparation, according to the Boston Bowel Preparation Scale (BBPS), and colonoscopy withdrawal time (CWT) on ADR and PDR in the adequate bowel preparation group.

Methods: Healthy examinees between 50 and 75 years old who underwent colonoscopy between September 2015 and August 2016 were included. BBPS scores, CWT, ADR, and PDR were reviewed retrospectively. Predictors of ADR and PDR were analyzed with a generalized linear mixed model.

Results: A total of 5073 cases with adequate bowel preparation (BBPS ≥ 6) were analyzed. Examinees with good (BBPS = 6, 7) and excellent (BBPS = 8, 9) bowel preparation were 1898 (37.4%) and 3175 (62.6%), respectively. Both ADR and PDR were higher in the good bowel preparation group than in the excellent bowel preparation group (ADR 47.3% vs. 45.0%, P = 0.035; PDR 73.7% vs. 69.5%, P = 0.004, respectively). In the multivariate analysis, CWT, rather than BBPS, was significantly associated with both ADR (OR 1.04; 95% CI 1.02-1.06; P < 0.001) and PDR (OR 1.05; 95% CI 1.02-1.07; P = 0.002).

Conclusions: Both ADR and PDR were lower when bowel preparation was excellent rather than good. However, CWT, not BBPS, was significantly associated with ADR and PDR in the adequate bowel preparation group. Therefore, meticulous inspection is important for high-quality colonoscopy regardless of the BBPS score in examinees with adequate bowel preparation.

Keywords: Adenoma detection rate; Boston Bowel Preparation Scale; Colonoscopy withdrawal time; Polyp detection rate.

PubMed Disclaimer

References

    1. Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66:683–691. - DOI
    1. Leslie A, Carey FA, Pratt NR, Steele RJ. The colorectal adenoma–carcinoma sequence. Br J Surg. 2002;89:845–860. - DOI
    1. Force USPST, Bibbins-Domingo K, Grossman DC, et al. Screening for colorectal cancer: US preventive services task force recommendation statement. JAMA. 2016;315:2564–2575. - DOI
    1. Zauber AG, Winawer SJ, O’Brien MJ, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012;366:687–696. - DOI
    1. Klabunde CN, Joseph DA, King JB, White A, Plescia M. Vital signs: colorectal cancer screening test use: United States, 2012. Mmwr-Morbid Mortal W. 2013;62:881–888.

LinkOut - more resources