If you could only ask your gastroenterologist one question before going into your colonoscopy, what would it be? Some popular choices might be, “What medical school did you attend?”or “How many years of experience do you have in the field?”
While the answers to these questions might satisfy your curiosity, these are not the qualifying questions that make a good gastroenterologist. According to new research, the most important question that you should ask of your gastroenterologist before you have your colonoscopy is, “What is your adenoma detection rate?”
Douglas Corley, M.D., a gastroenterologist at Kaiser Permanente in Oakland, California, led a study that analyzed records of 224,000 patients from California. Dr. Corley and his research team determined that when doctors had a higher adenoma detection rate, their patients had a lower risk of developing or dying from colon cancer. In fact, for every 1 percent increase in a doctor’s adenoma detection, the patient’s risk of developing colon cancer over the next 10 years lowered by 3 percent. Dr. Corley suspects that this decrease is because precancerous polyps never have the opportunity to develop into anything suspicious or cancerous.
So what is a “good” or “bad” detection rate? Lawrence Kim, M.D., community private practice councilor for the American Gastroenterological Association, said that these benchmarks have been proposed: 25 percent rate or higher for men and 15 percent or higher for women. Detection rates should be higher in men because adenomas are more common in men. In the California study, adenoma detection rates varied from as low as 7 percent to as high as 52 percent.
This research study may be an important milestone in how quality-of-care is assessed and documented in the future. It should be noted that many factors could skew a doctor’s adenoma detection rate to be higher or lower than average. Dr. Corley says detection rates can be affected by “just the random variation in the patients doctors see.” For example, a doctor who sees a majority of older male patients in any given year may be no more competent than a doctor who sees younger female patients, but the detection rates would make one assume that the doctor with the higher average is a more qualified gastroenterologist.
Dr. Corley is continuing his study to analyze whether better training helps improve adenoma detection among doctors with lower ratings. Someday, adenoma detection rates may be documented and made available to the public, although for now it will have to suffice to just ask your gastroenterologist—preferably before the happy drugs kick in (Source: Newsmax Health).