Polyp Detection Rate during Colonoscopy Is Correlated with Quality of Bowel Preparation: 1463

Purpose: The rate of polyp detection during colonoscopy may be impacted by the skill of the endoscopist, scope withdrawal time and adequacy of bowel preparation. To better understand these issues, we conducted an analysis of pts enrolled in a study designed to compare the efficacy and safety of 2 bowel preparations. Methods: In a post-hoc analysis, we evaluated the No. of colon polyps detected during a randomized, investigator-blinded, multicenter study comparing a new 32-tablet sodium phosphate (NaP) prep (OSMOPREP) with 2L PEG + 4 bisacodyl (BIS) tabs (HALFLYTELY). NaP tabs were taken as a split dose on the evening before (n = 20) and 3–5 hrs prior to (n = 12) colonoscopy. PEG+BIS was taken at noon on the day prior to colonoscopy (BIS tabs) and then ∼∼6 hrs later (PEG). Overall colon cleansing (OCC) was assessed by the investigator using a 4-point scale (1 = excellent 2 = good 3 = fair 4 = inadequate). Endoscopic interventions were classified as biopsy, lesion cauterization, polypectomy or polyp ablation. The total No. of polypectomies plus polyp ablations was used as a surrogate indicator for colon polyps. A Cochran-Mantel-Haenszel Row Mean Score Test w/modified ridit scores was performed. Results: 205 pts taking NaP tabs and 206 pts taking PEG+BIS underwent colonoscopy. No significant differences in pt demographics (age, gender, race, wt) were observed between groups. Mean OCC score was significantly better with NaP tabs vs 2L PEG+BIS (1.5 ± 0.74 vs 1.8 ± 0.76 p < 0.0001). 124 and 118 pts in the NaP tab and PEG+BIS groups had 281 and 248 interventions, respectively. Adjusting for grading of OCC, a significant correlation was observed between treatment and No. of polyps (p= 0.041). Additionally there was an association between quality of cleansing and frequency of intervention among pts using NaP tab prep (p= 0.035); a significantly higher proportion of pts taking NaP vs PEG+BIS had 1 or more intervention when colon cleansing was rated excellent (60% vs 36% p= 0.0002). NaP tabs were associated with a shorter adjusted procedure time (14.2 ± 5.77 vs 15.9 ± 6.16 min p= 0.0124). Conclusions: The new NaP tablet prep was associated with an increased rate of polyp detection compared with 2L PEG+BIS. As anticipated, polyp detection increases as the grade of colon cleansing improves. These findings reinforce the clinical importance of achieving excellent colon cleansing results.