Becker's ASC Review

Sept/Oct 2016 Issue of Becker's ASC Review

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47 10 Things to Know About Adenoma Detection By Jessica Kim Cohen H ere are 10 things to know about adenoma detection. Here are 10 things to know about adenoma detection. 1. A physician's "adenoma detection rate" is used as a colonos- copy quality indicator. ADR is defined as the percentage of patients for which the physician detected at least one adenoma, according to the American College of Gastroenterology. 2. To hit benchmark, a physician's ADR should be at least 25 percent for male patients and 15 percent for female patients. e most effec- tive way to increase a physician's ADR may be additional education and training, rather than changes in technology, according to a 2013 study in Nature. 3. Screening guidelines from the American College for Gastroenter- ology for colonoscopy note: • Patients with more than 10 adenomas should receive another colonoscopy in less than three years. • ose with between three and 10 tubular adenomas, at least one large tubular adenoma or at least one villous adenoma should receive another colonoscopy in three years. • ose with one or two small tubular adenomas should receive another colonoscopy in five to 10 years. 4. By detecting adenomas and other precancerous polyps, screen- ings prevented about half of the expected new cases and deaths from colorectal cancer between 2003 and 2007, according to a 2011 CDC report. 5. e average gastroenterologist performs 21 colonoscopies a month, 45.8 percent of which are dedicated to screening, according to a 2004 study in the journal Alimentary Pharmacology & erapeu- tics and reported in Medscape. e study also estimated that around 1.69 million patients receive screening-related colonoscopies each year, 1.27 million of which are performed by gastroenterologists. 6. e study in Alimentary Pharmacology & erapeutics concluded that there are not enough gastroenterologists to meet patient de- mand, since the annual demand for colonoscopy ranges from 2.21 million to 7.96 million. e study goes on to say that 1,360 gastroen- terologists would need to be added to meet this demand. 7. Total annual compensation for gastroenterologists is $370,000, ranking the third highest-paid medical specialty, according to the Medscape Gastroenterologist Compensation Report 2015. 8. While gastroenterologists, general surgeons and primary care physicians might perform colonoscopies, studies have shown that gastroenterologists tend to provide higher quality care in three ar- eas of performance: they are less likely to miss colorectal cancer, less likely to have complications and more likely to hit quality guidelines, according to the American College of Gastroenterology. 9. Colonoscopies are the most expensive screening test that healthy Americans regularly receive, according to the New York Times. With- out additional charges included, the average price for a colonoscopy in the United States in 2012 was $1,185. 10. A controversial issue is physician and patients' preferred method of colorectal cancer screening. While colonoscopy is the standard method, other techniques have also proven accurate in re- cent studies. In a 2008 study in the New England Journal of Medicine, CT colonography (or "virtual colonoscopy") identified 90 percent of subjects with adenomas or cancers measuring 10 millimeters or more in diameter. n BECKER'S ASC 23 RD ANNUAL MEETING the business and operations of ASCs 125 Speakers From Surgery Centers, 54 Surgeons Speaking, 61 ASC Administrators Speaking 206 TOTAL SPEAKERS october 27-29, 2016 swissotel, chicago Call 1.312.750.6016 or email registration@beckershealthcare.com or visit beckersasc.com/annual-ambulatory- surgery-centers-conferences/ Keynotes from Pat Riley, Sugar Ray Leonard and Lee Woodruff

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