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Douglas Corley, MD, PhD

Gastroenterology, San Francisco

“The main driver behind this study is to find out if we can do better at detecting colon cancer. We learned that yes, even when you’re meeting quality standards, it’s possible to do better.”

Douglas Corley, MD, PhD, led a team that evaluated the association between physician adenoma detection rate (ADR) and colorectal cancer, the second leading cause of cancer death. Adenomas are precancerous polyps found at colonoscopy. “ADRs vary widely between physicians, even among those meeting national standards,” said Dr. Corley. “We evaluated if this variation makes a difference in patients’ subsequent cancer risk.”

It does. In their study, Adenoma Detection Rate and Risk of Colorectal Cancer and Death, published in the New England Journal of Medicine (April 2014), patients of physicians with higher ADRs were at lower risk of developing future colorectal cancers. Each 1% increase in ADR predicted a 3% decrease in future colorectal cancer risk—and a 5% decrease in fatal cancers.

“Our findings validate ADR as an important quality metric for colonoscopy and suggest that increasing ADRs may even further improve the effectiveness of colorectal cancer screening,” said Dr. Corley. In accordance with his and other research, the American Society for Gastrointestinal Endoscopy increased its ADR thresholds for quality assurance.

As the largest study of its kind and the first US study to validate the link between adenoma detection and colorectal cancer risk, Dr. Corley’s efforts promise to improve care for Kaiser Permanente members and patients across the country.

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