The Proportion of Colonoscopies Performed by a Physician with at Least

question 321

Multiple Choice

The proportion of colonoscopies performed by a physician with at least 1 detected adenoma is called the adenoma detection rate.  A study examined the association between the adenoma detection rate and the risk of colorectal cancer 6 months to 10 years after colonoscopy.  In the graph below, physicians were sorted into quintiles based on their adenoma detection rate, with quintile 1 being the lowest rate of detection and quintile 5 being the highest.  There were no significant differences in rates of complications.  The hazard ratios (HRs) , shown along with their corresponding 95% confidence intervals (CIs) , were adjusted for other variables including patient age, sex, comorbidities, and indication for colonoscopy. Which of the following statements best describes the study results?

• A)Adenoma detection rate could be a useful quality measure of a physician's colonoscopy performance
• B)Adenoma detection rate is not associated with the incidence of colorectal cancer
• C)Patients with no adenomas can be safely followed for 10 years without repeat colonoscopy
• D)Physicians in quintile 3 prevent significantly more colorectal cancers than those in quintile 1
• E)The risk of colorectal cancer appears to increase with higher adenoma burden

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