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PWE-053 Variation In Adenoma Detection Rate In Bowelscope Screening
  1. R Bevan1,2,
  2. C Nickerson3,
  3. R Blanks4,
  4. J Patnick3,
  5. R Loke5,
  6. B Saunders6,
  7. J Stebbing7,
  8. R Tighe8,
  9. A Veitch9,
  10. J Painter2,
  11. CJ Rees1,2,10
  1. 1Northern Region Endoscopy Group, Newcastle Upon Tyne, UK
  2. 2South of Tyne and Wear BCSC, Gateshead, UK
  3. 3NHS Cancer Screening Programmes, Sheffield, UK
  4. 4Cancer Epidemiology Unit, Oxford, UK
  5. 5West Kent and Medway BCSC, Tunbridge Wells, UK
  6. 6St Marks BCSC, London, UK
  7. 7Surrey BCSC, Guilford, UK
  8. 8Norwich BCSC, Norwich, UK
  9. 9Wolverhampton BCSC, Wolverhampton, UK
  10. 10Durham University, Stockton on Tees, UK

Abstract

Introduction The English Bowel Cancer Screening Programme has been expanded to include a one-off flexible sigmoidoscopy offered to all 55 year olds, called BowelScope Screening. Screening commenced in May 2013, with 6 pilots sites performing flexible sigmoidoscopies in the first 8 months of screening.

Methods The NHS Bowel Cancer Screening System database was interrogated and ADRs reviewed for each screening centre and screening endoscopist. A funnel plot was constructed using the log odds method.

Results 49 endoscopists have performed 4444 sigmoidoscopies at 6 screening centres. Endoscopists had performed 2–330 procedures (median 66, mean 91), 29 endoscopists had performed ≥50 procedures, of these, 17 had performed ≥100 procedures. Overall BowelScope ADR is 8.6%. ADR by centre is shown in Table 1.

Abstract PWE-053 Table 1

ADR by centre and volume

Centre 2 has a higher ADR than the other centres. When considering all procedures, this difference reaches statistical significance when compared to centres 3, 5, and 6 (p < 0.05), and approaches significance when compared to centre 1 (p = 0.0687) and centre 4 (p = 0.0548). When considering procedures done by endoscopists who have performed ≥50 or ≥100 sigmoidoscopies, there remains a significant difference (p < 0.05) between centre 2 compared to centres 5 and 6, but not to the other centres. Creating a funnel plot of individual endoscopist ADRs, demonstrates one endoscopist below the 99.8% control limit (Figure 1).

Conclusion Adenoma detection rates within BowelScope screening show variation between centres. There is also variation between endoscopists in terms of individual ADRs, although all but 1 endoscopist are above the 99.8% lower control level on funnel plot. These variations require further exploration at both centre and individual level; feedback and education methods will be used to improve ADRs. Consideration should be given to establishing an ADR standard.

Disclosure of Interest None Declared.

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