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 > or =1 nonadenomatous 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 > or =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.