Incorporating Based-Risk Clinical Parameters to the Assessment on Polyps and Adenomas Detection Rates in Colorectal Cancer Screening

Khader M, Artoul R, Delgado JS and Naim AF

The Gastroenterology Institute, Assuta Medical Center

^*Correspondance to: Majd Khader 

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Abstract:

Background and Aim: Colorectal Cancer (CRC) remains a major global health issue, with early detection significantly improving prognosis. Current screening guidelines primarily emphasize age and family history, but other clinical and laboratory parameters could enhance detection rates. Our study investigates the correlation between CRC-related manifestations and screening performance metrics–Polyp Detection Rate (PDR) and Adenoma Detection Rate (ADR). Methods: This cross-sectional retrospective study analyzed 235,781 colonoscopy procedures from eight multi-center sites affiliated with Assuta Medical Centers in Israel, conducted between 2016 and 2022. The dataset comprised the identification and classification of polyps, adenomas, and Colorectal Cancer (CRC), in conjunction with patient demographics, clinical background, and particular clinical-laboratory manifestations including hematochezia, abdominal pain, family history of CRC, fecal occult blood results and presence of anemia. Quality performance metrics PDR and ADR, as well as potential associations with clinical and laboratory manifestations were computed. Results: Our study found significant variations in PDR and ADR based on symptom presence. Patients with hematochezia exhibited a PDR of 36.8% and an ADR of 12.1%, compared to 28.7% and 10.8% in those without it. Moreover, patients with fecal occult blood had a PDR of 48.3% and an ADR of 21.5%, compared to 31.6% and 11.0% in those without it. In addition, a family history of CRC also correlated with higher PDR and ADR. Our data also showed that clinical combinations, particularly CRC family history with hematochezia, displayed the highest PDR at 62.3% and ADR at 11.2%, while combinations involving others such as abdominal pain and anemia were less predictive. Conclusion: Our research indicates that the integration of clinical and laboratory parameters, including the presence of hematochezia and fecal blood occult test, into Colorectal Cancer (CRC) screening protocols could substantially augment the early identification of the disease and enhance screening efficacy. Symptoms, especially when considered in conjunction with a familial predisposition for CRC, seem to serve as significant predictors for pinpointing individuals at elevated risk. These findings support the necessity for a reformed screening paradigm that employs symptom-based criteria to optimize strategies for CRC prevention and detection.

Keywords:

Colorectal cancer; Adenoma Detection Rate (ADR); Polyp Detection Rate (PDR); CRC Related Symptoms; Early Detection

Cite the Article:

Khader M, Artoul R, Delgado JS and Naim AF. Incorporating Based-Risk Clinical Parameters to the Assessment on Polyps and Adenomas Detection Rates in Colorectal Cancer Screening. Clin Oncol. 2024;9:2107..