High Polyp Detection is Factor in Preventing Colon Cancer

March 11, 2019
Dr. Elizabeth Huebner
Dr. Chien-Huan Chen

As Barnes-Jewish West County Hospital (BJWCH) recognizes March as Colon Cancer Awareness Month, its gastroenterology (GI) department is highlighting one of its strongest quality indicators based on results from colonoscopies performed at the hospital.

Thanks to several contributing factors, the BJWCH GI department had one of its highest tracked Adenoma Detection Rates (ADR) during the third quarter of 2018. These adenomas - or polyps - could lead to colon cancer, if not identified and removed during a screening colonoscopy.

High Polyp Detection Rates Mean Decreased Risk of Developing Cancer

“One important quality indicator that we look at as endoscopists is the adenoma detection rate, which refers to the proportion of average risk patients age 50 or older undergoing screening colonoscopies where at least one adenoma (precancerous polyp) is identified,” explains Elizabeth Huebner, MD, Washington University gastroenterologist at BJWCH. “Higher ADRs have been associated with a decreased risk of developing interval colon cancer before the patient’s next colonoscopy.”

Routinely monitored by Chien-Huan Chen, MD, PhD, Washington University gastroenterologist at BJWCH, the BJWCH ADR is based on the recommended benchmark for all patients — 25 percent (30 percent in men and 20 percent in women). During the 2018 third quarter, the ADR for BJWCH was 50.44 percent.

Gastroenterology Team Focuses on Exceptional Quality

Dedicated, highly-trained GI team at Barnes-Jewish West County Hospital is key to high polyp detection rates.

“We attribute the high number at BJWCH to the quality of our physicians and well-trained GI staff who are dedicated to providing excellent care to our patients,” Dr. Chen says. “Barnes-Jewish West County Hospital’s use of state-of-the-art equipment (scopes) and ensuring our patients are adequately prepped is also key to quality.”

In addition, how soon a patient may return for a colonoscopy is often based on several factors surrounding the detected polyps. These include:

  • How many polyps are removed
  • The size of the polyps removed
  • What kind of polyps are removed
  • How the polyp was removed

“All of these factors can determine whether a patient may return in three, five or 10 years,” Dr. Chen explains.

Tracking Leads to Awareness and Better Patient Outcomes

Dr. Chen says there are several reasons why ADR is tracked, but the primary reason is due to the fact that although gastroenterologists treat many different conditions, their one commonality is that they all perform colonoscopies as part of their specialty, and ADR is the most important and universally accepted quality indicator for colonoscopy.

The tracking of ADR first began with Washington University physicians by Dr. Chen in 2013. By 2015, Washington University began working with the BJC Center for Clinical Excellence to monitor ADR across the entire BJC HealthCare system.

“We’ve been tracking ADR for a while now, and we are continually seeing improvements, which results in better outcomes for our patients,” says Dr. Chen, who adds that the benchmark of ADR is from the American Society of Gastrointestinal Endoscopy.

Dr. Chen also attributes BJWCH’s high ADR to the hospital’s endoscopy lab, which consistently has high patient satisfaction results.

“The pre-procedure, post-procedure staff, technicians, nurses and entire team are very competent and dedicated throughout the patient experience and is why we have very high patient satisfaction,” he said.

ADR is tracked every quarter, and Dr. Chen provides all physicians with updated confidential information to increase awareness and allow for any improvements.

Schedule a Colonoscopy

To schedule your colonoscopy, please call 314-878-1950 or request an appointment online.


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