Substantial and sustained improvement of serrated polyp detection after a simple educational intervention: results from a prospective controlled trial.

Abstract:

OBJECTIVE:Serrated polyps (SPs) are an important cause of postcolonoscopy colorectal cancers (PCCRCs), which is likely the result of suboptimal SP detection during colonoscopy. We assessed the long-term effect of a simple educational intervention focusing on optimising SP detection. DESIGN:An educational intervention, consisting of two 45 min training sessions (held 3 years apart) on serrated polyp detection, was given to endoscopists from 9 Dutch hospitals. Hundred randomly selected and untrained endoscopists from other hospitals were selected as control group. Our primary outcome measure was the proximal SP detection rate (PSPDR) in trained versus untrained endoscopists who participated in our faecal immunochemical test (FIT)-based population screening programme. RESULTS:Seventeen trained and 100 untrained endoscopists were included, who performed 11 305 and 51 039 colonoscopies, respectively. At baseline, PSPDR was equal between the groups (9.3% vs 9.3%). After training, the PSPDR of trained endoscopists gradually increased to 15.6% in 2018. This was significantly higher than the PSPDR of untrained endoscopists, which remained stable around 10% (p=0.018). All below-average (ie, PSPDR ≤6%) endoscopists at baseline improved their PSPDR after training session 1, as did 57% of endoscopists with average PSPDR (6%-12%) at baseline. The second training session further improved the PSPDR in 44% of endoscopists with average PSPDR after the first training. CONCLUSION:A simple educational intervention was associated with substantial long-term improvement of PSPDR in a prospective controlled trial within FIT-based population screening. Widespread implementation of such interventions might be an easy way to improve SP detection, which may ultimately result in fewer PCCRCs. TRIAL REGISTRATION NUMBER:NCT03902899.

journal_name

Gut

journal_title

Gut

authors

Bleijenberg AGC,van Leerdam ME,Bargeman M,Koornstra JJ,van Herwaarden YJ,Spaander MC,Sanduleanu S,Bastiaansen BAJ,Schoon EJ,van Lelyveld N,Dekker E,IJspeert JEG

doi

10.1136/gutjnl-2019-319804

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

2150-2158

issue

12

eissn

0017-5749

issn

1468-3288

pii

gutjnl-2019-319804

journal_volume

69

pub_type

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