50 - Use of Mechanical Enhanced Colonoscopy to Improve Polyp Detection During Colorectal Cancer Screening: A Preliminary Results of Real-World Healthcare Database Analysis

Seth A. Gross, MD
NYU Langone Health, New York, NY

Introduction: Colonoscopy is the gold standard for colon cancer screening. However, there is a known polyp miss rate due to inadequate mucosal exposure. The aim of the study was to evaluate the effectiveness of mechanical enhancement, Endocuff-assisted colonoscopy (EAC), in polyp detection rate (PDR) and estimated adenoma detection rate (eADR) compared to the standard colonoscopy (SC) with real world data (RWD).



Methods: Four years of data (1/2018–12/2021) from the Premier Healthcare Database were analyzed. ICD_10 code: Z12.11, CPT codes (45378, 45380, 45381, 45382, 45384, 45385, 45386, 45388, 45389, 45390, 45398) and, HCPCS codes G0105, G0121 were used to identify patients aged 50 years and older, having screening colonoscopy. A keyword search for Endocuff was used to identify the EndoCuff case utilization. The colonoscopy in which the polyp was found was identified by ICD10 codes (D12.X, D1.X, K63.5, K51.4, C18-21.X ). Data analysis was limited to procedures performed by Gastroenterologists, and patients with family/personal history of cancer/polyps were excluded. PDR was calculated as proportion of patients who have at least one polyp. eADR was calculated by multiplying PDR by 0.72 according to the method of Vojtechova G et al¹. Logistic regression model was used to examine the different on PDR between with and without Endocuff group after controlling for patient and provider characteristics.

1. Vojtechova G, et al. Eur J Cancer Prev. 2020;29(4):294-302

Results: 893,560 screening colonoscopies, of which 0.7% (n = 5,892) and 99.3% (n = 887,668) using EAC and SC, respectively. Gender, age, and race were similar in both groups. Overall PDR and eADR were 72.0% (95% confidence interval; 70.8%-73.1%) vs 57.4% (57.3%-57.5%), 51.8% (51.0%-52.6%) vs 41.3% (41.2%-41.4%) for EAC vs SC, respectively (table 1). Compared to SC, the EAC group demonstrated higher PDR and eADR regardless of age, gender, race/ethnicity, and number of colonoscopies per physician in 4 years of study duration. The unadjusted and adjusted odds ratios of PDR of EAC to SC were 1.91 (95%CI 1.80-2.02) and 2.01 (95%CI 1.90-2.13), respectively.

Discussion: Our preliminary results demonstrated mechanical enhancement assisted colonoscopy, EndoCuff, improves PDR and eADR for CRC screening in real-world clinical setting.. The results are similar to other studies published in the literature. However, the use of EndoCuff is still very low and more data are needed to validate its efficacy in both polyp detection and ADR..





Disclosures:


Seth A. Gross, MD, 50, Use of Mechanical Enhanced Colonoscopy to Improve Polyp Detection During Colorectal Cancer Screening: A Preliminary Results of Real-World Healthcare Database Analysis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.