Colonoscopy Scheduling Influences Adenoma and Polyp Detection Rates

Background/Aims: Because colonoscopy can be a technically challenging procedure, endoscopist fatigue, which usually increases as day progresses, may impact procedural performance. The aim of this study was to determine the influence of colonoscopy scheduling on adenoma and polyp detection rates (ADR and PDR, respectively). Methodology: This was a retrospective study of data prospectively collected on 1,293 consecutive, asymptomatic, average-risk patients. Three separate timing variables were assessed, as follows: morning vs. afternoon procedures; start times throughout the day; and four groups by matching each subsequent passing hour in the morning and afternoon sessions. Results: 420 (32%) were performed in the morning and 881 (68%) were performed in the afternoon. There was a significantly higher ADR and PDR in the morning colonoscopies compared to the afternoon colonoscopies (42.3% vs. 34.7% [p=0.008] and 52.5% vs. 46.3% [p=0.038], respectively). Based on multivariable analysis, afternoon colonoscopies and colonoscopies performed during 4th hour of session were significantly associated with a decreased ADR (OR, 0.739 [0.576-0.949], p=0.018; and OR, 0.651 [0.443-0.975], p=0.029). Conclusions: Colonoscopies scheduled in the morning have a significantly higher ADR and PDR as compared to colonoscopies scheduled in the afternoon. Also colonoscopies performed during 4th hour of the session were associated with decreased ADR.