Patient-, endoscopist-, and procedure-related factors associated with adenoma detection in first screening colonoscopies at a Lebanese tertiary hospital: a retrospective cohort study

Abstract Background Colorectal cancer (CRC) is a leading cause of cancer-related deaths worldwide, and is largely preventable through colonoscopy, during which adenomatous polyps can be detected and removed. The adenoma detection rate (ADR) and polyp detection rate (PDR) are key quality indicators of colonoscopy quality and are inversely associated with post-colonoscopy CRC. These indicators may be influenced by patient-, physician-, and procedure-related factors. This study aimed to evaluate the ADR and PDR, identify factors influencing these indicators, and compare them among gastroenterologists at a Lebanese medical center. Methods This observational, single-center, retrospective cohort study included 257 patients aged 50–75 years who underwent first-time screening colonoscopy over 3 years. Data on patient characteristics and colonoscopy findings were collected. ADR and PDR were calculated according to established guidelines, with ADR additionally estimated using the adenoma-to-polyp detection rate quotient (APDRQ). Descriptive statistics were applied, and chi-square or Fisher’s exact tests were used to assess associations between patient-, physician-, and procedural related factors and adenoma detection. Results Out of 257 patients, 159 had polyps detected during colonoscopy. The overall ADR was 44.4%, and the PDR was 61.8% over the three-year study period. The ADR was 52.1% in men and 38.0% in women, whereas the PDR was 68.6% in men and 56.3% in women. Although the overall ADR and PDR met or exceeded the recommended benchmarks, disparities were noted in detection rates between males and females. Bowel preparation quality and guarantor type significantly influenced adenoma detection, whereas other factors related to patients and endoscopists had no significant effect. The estimated ADRs derived from the PDRs for five endoscopists were also high, surpassing the 25% benchmark; however, their annual estimated ADRs were relatively below this threshold. Conclusion This study provides valuable regional data and underscores the need for standardized quality monitoring and further multicentric prospective research to optimize CRC prevention in Lebanon.