CHICAGO, January 12, 2023 — Cancer-causing polyps in the colon become more common on the right side of the colon as we age, according to recently published research. This finding has the potential to create a new quality metric for gastroenterologists and could lower the rate of post-colonoscopy cancer diagnoses.
The study, published in Techniques and Innovations in Gastrointestinal Endoscopy, parsed claims data in the Health Care Service Corporation database covering all screening colonoscopies performed between 2016 and 2018 (N = 597,377). Researchers measured the adenoma detection rate (ADR) of both the proximal (right) colon and distal (left) colon.
In addition to confirming previous data that polyps increase as populations age, they also reported new data demonstrating that the increase with age is due to a disproportionate rise in the number of polyps on the right side of the colon as opposed to those on left side, regardless of race or gender.
“That’s a problem, because proximal colon polyps tend to be flatter and therefore more difficult for gastroenterologists to find than those in the distal colon,” said Lawrence Kosinski, MD, a gastroenterologist, chief medical officer of SonarMD, and the study’s lead author. “It may explain why cancers that develop between colonoscopies are typically caused by polyps in the proximal colon.”
Not only can these findings help gastroenterologists find more cancer-causing polyps, they can also be used to create a new quality metric to measure the effectiveness of GI care.
Currently, overall ADR — the proportion of colonoscopies performed that detect a polyp — is a common quality metric for gastroenterologists. A higher ADR is associated with lower rates of post-colonoscopy colorectal cancers.
Because polyps become more common as we age, the authors proposed that overall ADR should be normalized by the age of the patient population. Additionally, they proposed that P-ADR, the adenoma detection rate in the proximal colon, could be an important new quality metric in addition to overall ADR.
“Normalizing ADR by age and adding P-ADR as a quality metric can help decrease the wide variation in ADR among gastroenterologists and facilitate value-based arrangements,” said Dr. Kosinski. “And, ultimately, our hope is that this will lead to more effective screening colonoscopies and better patient outcomes.”
Colorectal cancer and GI conditions such as Crohn’s disease drive up the cost of healthcare and result in poor patient outcomes. Research using claims data is imperative to uncover ways to improve patient outcomes, lower the cost of care, and prove out that gastroenterologists have a role to play in healthcare’s value-based future.
“These findings are based on a lot of hard work done by Dr. Kosinski and our payer partners,” said Beth Houck, CEO, SonarMD. “This research serves as yet another example of SonarMD’s commitment to collaborating with health plans to analyze data, improve quality, and advance specialty value-based care.”
Dr. Kosinski is a well-published researcher with a history of parsing claims data to find interesting solutions. In fact, a prior data analysis conducted in concert with a health plan — which showed that proactively engaging with Crohn’s disease patients can lower the cost of care and improve clinical outcomes — is what led to the founding of SonarMD.
About SonarMD
SonarMD aligns incentives around the doctor-patient relationship to reimagine care for complex chronic diseases, starting in gastroenterology. Using AI technology and human support, we predict clinical deterioration in patients and make it easier for patients and specialists to work together to proactively address problems before they become health emergencies. Our approach is proven to keep people healthier and help health plans reduce costs by 15% per member per year. For more information, visit SonarMD.com.
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