Grant Number:	1R01CA131141-01A1 Interpret this number
Primary Investigator:	Dietrich, Allen
Organization:	Dartmouth College
Project Title:	Variations in Colonoscopy Screening: a Population Based Study
Fiscal Year:	2008

DESCRIPTION (provided by applicant): Colonoscopy affords the opportunity for detection and removal of polyps and thus can prevent the development of colorectal cancer (CRC). Colonoscopy is not an unlimited resource. Its appropriate utilization is critical to optimizing CRC screening. Wide variations exist in colonoscopy practice and outcomes. Understanding these variations and the factors contributing to the most effective and efficient outcomes would inform appropriate CRC screening in both community and academic settings. Through this innovative project we will characterize colonoscopy practices, outcomes and their variations for the New Hampshire (NH) adult population by expanding the NH Colonoscopy Registry to include a high proportion of NH colonoscopists, linking colonoscopy findings with patient factors and pathology results. This characterization will be dynamic, addressing current practices and how practices evolve over time including the impact of emerging technologies such as CT colonography and fecal DNA analysis. As findings accrue, we will explore their implications with key stakeholders leading to better understanding and to future quality improvement and research projects that improve the provision of colonoscopy to control CRC. This work is informed and inspired by work of population-based mammography registries over the past decade. One of these, the NH Mammography Network, will provide proven methods, practical experience, and a record of productivity to this project. The NH Mammography Registry principal investigator and staff play active and substantial roles in this new work on colonoscopy. Project aims include: AIM 1: To identify polypectomy rates, types of polypectomies, pathology findings, completion rates, and complications for screening, surveillance, and diagnostic colonoscopy, including adjustment for patient risk factors, using a state-based colonoscopy registry. AIM 2: To examine discrepancies between colonoscopists' recommendations for timing of repeat exams and recognized guidelines for specific patient subgroups. AIM 3: To identify sources of variation identified in Aim 1 and Aim 2, including the degree to which patient, colonoscopist, and practice setting factors contribute and have the potential for modification. AIM 4: To share findings from Aims 1-3 with key stakeholders (colonoscopists, primary care clinicians, and community members), explore their views on the implications of these findings, and develop insights on opportunities for intervention that could be addressed in subsequent proposals. AIM 5: To explore the impact of emerging technologies on colonoscopy as applied in both academic and community-settings. PUBLIC HEALTH RELEVANCE: Colorectal cancer is a major killer and colonoscopy is currently our best defense. Inspired and informed by the progress against breast cancer that has resulted from population- based mammography registries, this project will create a colonoscopy registry to advance our understanding of how it is provided in representative community and academic settings, the outcomes it currently achieves, and how the practice evolves as technology advances. To spur innovations, physician and community stakeholders will be engaged in interpreting the findings and developing actions needed to increase its quality and appropriate use.




Increased risk of metachronous large serrated polyps in individuals with 5- to 9-mm proximal hyperplastic polyps: data from the New Hampshire Colonoscopy Registry.
Authors: Anderson J.C. , Robinson C.M. , Butterly L.F. .
Source: Gastrointestinal Endoscopy, 2020 Aug; 92(2), p. 387-393.
EPub date: 2020-04-26 00:00:00.0.
PMID: 32348745
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Young adults and metachronous neoplasia: risks for future advanced adenomas and large serrated polyps compared with older adults.
Authors: Anderson J.C. , Robinson C. , Butterly L.F. .
Source: Gastrointestinal Endoscopy, 2019-11-21 00:00:00.0; , .
EPub date: 2019-11-21 00:00:00.0.
PMID: 31759925
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Association of small versus diminutive adenomas and the risk for metachronous advanced adenomas: data from the New Hampshire Colonoscopy Registry.
Authors: Anderson J.C. , Rex D.K. , Robinson C. , Butterly L.F. .
Source: Gastrointestinal Endoscopy, 2019 Sep; 90(3), p. 495-501.
EPub date: 2019-05-22 00:00:00.0.
PMID: 31125546
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Risk Factors for Diagnosis of Colorectal Cancer at a Late Stage: a Population-Based Study.
Authors: Andrew A.S. , Parker S. , Anderson J.C. , Rees J.R. , Robinson C. , Riddle B. , Butterly L.F. .
Source: Journal Of General Internal Medicine, 2018 12; 33(12), p. 2100-2105.
EPub date: 2018-10-03 00:00:00.0.
PMID: 30284171
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Smoking and Other Risk Factors in Individuals With Synchronous Conventional High-Risk Adenomas and Clinically Significant Serrated Polyps.
Authors: Anderson J.C. , Calderwood A.H. , Christensen B.C. , Robinson C.M. , Amos C.I. , Butterly L. .
Source: The American Journal Of Gastroenterology, 2018 12; 113(12), p. 1828-1835.
EPub date: 2018-11-01 00:00:00.0.
PMID: 30385834
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Risk of Metachronous High-risk Adenomas and Large Serrated Polyps in Individuals With Serrated Polyps on Index Colonoscopy: Data from the New Hampshire Colonoscopy Registry.
Authors: Anderson J.C. , Butterly L.F. , Robinson C.M. , Weiss J.E. , Amos C. , Srivastava A. .
Source: Gastroenterology, 2017-09-16 00:00:00.0; , .
EPub date: 2017-09-16 00:00:00.0.
PMID: 28927878
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Hyper-methylated Loci Persisting From Sessile Serrated Polyps To Serrated Cancers
Authors: Andrew A.S. , Baron J.A. , Butterly L.F. , Suriawinata A.A. , Tsongalis G.J. , Robinson C.M. , Amos C.I. .
Source: International Journal Of Molecular Sciences, 2017-03-02 00:00:00.0; 18(3), .
PMID: 28257124
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Providing Data For Serrated Polyp Detection Rate Benchmarks: An Analysis Of The New Hampshire Colonoscopy Registry
Authors: Anderson J.C. , Butterly L.F. , Weiss J.E. , Robinson C.M. .
Source: Gastrointestinal Endoscopy, 2017-01-30 00:00:00.0; , .
PMID: 28153571
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Adenoma Detection Rates For Screening Colonoscopies In Smokers And Obese Adults: Data From The New Hampshire Colonoscopy Registry
Authors: Anderson J.C. , Weiss J.E. , Robinson C.M. , Butterly L.F. .
Source: Journal Of Clinical Gastroenterology, 2017-01-05 00:00:00.0; , .
PMID: 28059941
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Impact of fair bowel preparation quality on adenoma and serrated polyp detection: data from the New Hampshire colonoscopy registry by using a standardized preparation-quality rating.
Authors: Anderson J.C. , Butterly L.F. , Robinson C.M. , Goodrich M. , Weiss J.E. .
Source: Gastrointestinal Endoscopy, 2014 Sep; 80(3), p. 463-70.
PMID: 24818550
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Serrated and adenomatous polyp detection increases with longer withdrawal time: results from the New Hampshire Colonoscopy Registry.
Authors: Butterly L. , Robinson C.M. , Anderson J.C. , Weiss J.E. , Goodrich M. , Onega T.L. , Amos C.I. , Beach M.L. .
Source: The American Journal Of Gastroenterology, 2014 Mar; 109(3), p. 417-26.
PMID: 24394752
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Distinct patterns of DNA methylation in conventional adenomas involving the right and left colon.
Authors: Koestler D.C. , Li J. , Baron J.A. , Tsongalis G.J. , Butterly L.F. , Goodrich M. , Lesseur C. , Karagas M.R. , Marsit C.J. , Moore J.H. , et al. .
Source: Modern Pathology : An Official Journal Of The United States And Canadian Academy Of Pathology, Inc, 2014 Jan; 27(1), p. 145-55.
PMID: 23868178
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Differences in detection rates of adenomas and serrated polyps in screening versus surveillance colonoscopies, based on the new hampshire colonoscopy registry.
Authors: Anderson J.C. , Butterly L.F. , Goodrich M. , Robinson C.M. , Weiss J.E. .
Source: Clinical Gastroenterology And Hepatology : The Official Clinical Practice Journal Of The American Gastroenterological Association, 2013 Oct; 11(10), p. 1308-12.
PMID: 23660415
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Perception of colonoscopy benefits: a gap in patient knowledge?
Authors: Yim M. , Butterly L.F. , Goodrich M.E. , Weiss J.E. , Onega T.L. .
Source: Journal Of Community Health, 2012 Jun; 37(3), p. 719-24.
PMID: 22109385
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Matching colonoscopy and pathology data in population-based registries: development of a novel algorithm and the initial experience of the New Hampshire Colonoscopy Registry.
Authors: Greene M.A. , Butterly L.F. , Goodrich M. , Onega T. , Baron J.A. , Lieberman D.A. , Dietrich A.J. , Srivastava A. .
Source: Gastrointestinal Endoscopy, 2011 Aug; 74(2), p. 334-40.
PMID: 21663907
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Improving the quality of colorectal cancer screening: assessment of familial risk.
Authors: Butterly L.F. , Goodrich M. , Onega T. , Greene M.A. , Srivastava A. , Burt R. , Dietrich A. .
Source: Digestive Diseases And Sciences, 2010 Mar; 55(3), p. 754-60.
PMID: 20058076
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The influence of smoking, gender, and family history on colorectal adenomas.
Authors: Onega T. , Goodrich M. , Dietrich A. , Butterly L. .
Source: Journal Of Cancer Epidemiology, 2010; 2010, p. 509347.
PMID: 20652068
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Disclosing harmful mammography errors to patients.
Authors: Gallagher T.H. , Cook A.J. , Brenner R.J. , Carney P.A. , Miglioretti D.L. , Geller B.M. , Kerlikowske K. , Onega T.L. , Rosenberg R.D. , Yankaskas B.C. , et al. .
Source: Radiology, 2009 Nov; 253(2), p. 443-52.
PMID: 19710002
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Colonoscopy demand and capacity in New Hampshire.
Authors: Butterly L. , Olenec C. , Goodrich M. , Carney P. , Dietrich A. .
Source: American Journal Of Preventive Medicine, 2007 Jan; 32(1), p. 25-31.
PMID: 17184962
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