EP573 - Is Longer Better? A Comparison of Adenoma Detection Rates Before and After the Updated Quality Indicators for Colonoscopies

Purpose/Background: Colorectal cancer is the second leading cause of cancer-related death in the United States, with colonoscopy as the gold standard screening method. In 2024, the American Society for Gastrointestinal Endoscopy (ASGE) and the American College of Gastroenterology (ACG) updated the colonoscopy quality indicators. These changes emphasized raising certain performance thresholds including cecal intubation rate from ≥ 90% to ≥ 95%, bowel preparation adequacy rate from ≥ 85% to ≥ 90%, withdrawal time from ≥ 6 to ≥ 8 minutes, and adenoma detection rate from ≥ 25% to ≥ 35%. Sessile serrated lesion (SSL) detection rate was introduced as a new quality indicator with an expected performance threshold of ≥ 6%. These changes were implemented in the Bronson Methodist Hospital system in Southwest Michigan on July 1st, 2025. Our study examines the impacts of these updated guidelines on adenoma detection in a single hospital system.

Methods/Interventions: This retrospective cohort study included all patients at least 18 years of age who underwent screening colonoscopy within a single hospital system, divided into two periods: Group 1 (April 1 - June 30, 2025) and Group 2 (July 1 - September 30, 2025). Demographics and procedural data were collected. Patients undergoing diagnostic colonoscopy, surveillance for inflammatory bowel disease or genetic cancer syndromes, or those with a personal history of colorectal cancer were excluded.

Results/Outcomes: Of the 1,973 patients, 964 were in Group 1 and 1,007 in Group 2. No significant differences were noted between the groups in the demographic data collected including age, sex, BMI, and smoking status. Cecal withdrawal time was significantly longer after implementation (12.2 minutes Group 1 vs 13 minutes Group 2, p< 0.0001). Cecal intubation rate was also significantly higher after implementation (97.2% Group 1 vs 98.6% Group 2, p=0.0278). No difference was seen in bowel preparation adequacy rate across the groups (97.4% Group 1 vs 97.7% Group 2, p=0.6510). Rates of detecting adenomas (52.2% Group 1 vs 52.8% Group 2, p=0.7721) and SSL (12.7% Group 1 vs 13.9% Group 2, p=0.4150) were similar between groups. Across the entire patient population, adenoma detection was significantly higher in male sex (55.4% male vs 49.4% female, p=0.0072) and patients with a body mass index (BMI) of greater than or equal to 30 (55.0% BMI ≥30 vs 50.1% BMI < 30, p=0.0300).

Conclusion/Discussion: Implementation of the new ASGE-ACG guidelines resulted in longer withdrawal times and higher cecal intubation rates. The detection rate of adenomas and sessile serrated lesions were slightly increased, though this was not significant.Table 1