mean polyp per patient is an accurate and readily obtainable surrogate for adenoma detection rate: results from an opportunistic screening colonoscopy program

background: the incidence of colorectal cancer is rising in several developing countries. in the absence of integrated endoscopy and pathology databases, adenoma detection rate (adr), as a validated quality indicator of screening colonoscopy, is generally difficult to obtain in practice. we aimed to measure the correlation of polyp-related indicators with adr in order to identify the most accurate surrogate(s) of adr in routine practice. methods: we retrospectively reviewed the endoscopic and histopathological findings of patients who underwent colonoscopy at a tertiary gastrointestinal clinic. the overall adr and advanced-adr were calculated using patient-level data. the pearson’s correlation coefficient ( r ) was applied to measure the strength of the correlation between the quality metrics obtained by endoscopists. results: a total of 713 asymptomatic adults aged 50 and older who underwent their first-time screening colonoscopy were included in this study. the adr and advanced-adr were 33.00% (95% ci: 29.52-36.54) and 13.18% (95% ci: 10.79-15.90), respectively. we observed good correlations between polyp detection rate (pdr) and adr ( r =0.93), and mean number of polyp per patient (mpp) and adr ( r =0.88) throughout the colon. there was a positive, yet insignificant correlation between advanced adrs and non-advanced adrs ( r =0.42, p =0.35). conclusions: mpp is strongly correlated with adr, and can be considered as a reliable and readily obtainable proxy for adr in opportunistic screening colonoscopy programs.