Variable detection of nonadenomatous polyps by individual endoscopists at colonoscopy and correlation with adenoma detection

Background: There is variation between endoscopists in their detection of colorectal adenomas. There is less understanding of variation between endoscopists in detection and management of nonadenomas. Aim: To describe the removal rates of nonadenomas, variability between endoscopists, and the association of adenoma removal with nonadenoma removal. Methods: Consecutive colonoscopy reports by 9 gastroenterologists at Indiana University Hospital between January 1999 and January 2004 were obtained. Patients with inflammatory bowel disease, polyp syndromes, or who were referred for polypectomy were excluded. Results: There were 10,034 included colonoscopies. The prevalence of nonadenomatous polyps increased from 26.6% at age 30 years to 29.3% at age 70 years (P = 0.02); this association was much less powerful than that of age with removal of adenomas. The range of finding >= 1 nonadenomatons polyp was 11.8% to 34.9%. The correlation between adenoma detection and nonadenoma removal by individual endoscopists for the full cohort was 0.79 and for persons age >= 50 years was 0.84. Conclusions: Detection of nonadenomatous polyps by individual endoscopists at colonoscopy is highly variable and correlates with increased removal rates of adenomatous polyps.