eP517 - Use of Mechanical Enhanced Colonoscopy to Improve Polyp Detection for Colorectal Cancer Screening by Surgeons: Results of Real-World Healthcare Database

Purpose/Background: Colonoscopy is the gold standard for colon cancer screening. However, there is a known polyp miss rate, one reason is inadequate mucosal exposure. The aim of the study was to evaluate the effectiveness of mechanical enhancement, Endocuff-assisted colonoscopy (EAC) by surgeons, in polyp detection rate (PDR) and estimated adenoma detection rate (eADR) compared to the standard colonoscopy (SC) with real world data (RWD).Methods/Interventions: Four years of data (1/2018–12/2021) from the Premier Healthcare Database were analyzed. ICD_10 and CPT codes and, HCPCS codes 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. Data analysis was limited to procedures performed by operators with Colon/Rectal Surgery (CRS) or General Surgery (GS) specialties, 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 al 1. Logistic regression model was used to examine the different on PDR between with and without Endocuff group after controlling for patient and provider characteristics.11) Vojtechova G, et al. Eur J Cancer Prev. 2020;29(4):294-302Results/Outcomes: 234,962 screening colonoscopies performed by surgeons, of which 0.5% (n = 1,079) and 99.5% (n = 233,883‬) using EAC and SC, respectively. Gender and age were similar in both groups. Overall PDR and eADR were 55.6% (95% confidence interval; 52.6%-58.6%) vs 43.7% (43.5%-43.9%), 40.0% (37.9%-42.2%) vs 31.4% (31.3%-31.6%) 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 1.62 (95%CI 1.43-1.82) and 1.61 (95%CI 1.42-1.82), respectively.Conclusion/

Discussion: Our preliminary results demonstrated mechanical enhancement assisted colonoscopy, EndoCuff, improves PDR and eADR for CRC screening by surgeons 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.PDR and eADR rates comparing standard colonoscopy to Endocuff assisted colonoscopy