PTU-083 Time of day influences colonoscopy outcome measures

Introduction Endoscopic surveillance and removal of adenomas significantly reduces the incidence and mortality of colorectal cancer. There is concern that time of day could affect colonoscopy outcomes due to endoscopist fatigue over the course of the day. This could lead to interval cancers, and ultimately increased mortality. However, there are few studies in this area, and they have yielded inconsistent results. The aim of this study was to investigate whether evening colonoscopy lists achieve the same outcomes as daytime lists. Methods Colonoscopy data from patients on the symptomatic pathway was gathered retrospectively over a one year period. Data was gathered only from endoscopists doing both daytime and evening lists. Data collected included quality of bowel prep, caecal intubation rate, adenoma detection rate (ADR), and colorectal cancer detection. Colonoscopy outcome data was compared between daytime and evening lists. Data was analysed using the χ2 test, and Fishers exact test. Results 1150 colonoscopies were included in the analysis, of which 845 were from daytime lists, and 305 were from evening lists. Time of day produced a near significant difference in ADR [23.2% (n=196) daytime vs 17.97% (n=55) evening, p=0.0581]. Detection of colorectal cancer was significantly lower in evening lists [2.13% (n=18) daytime vs 0.33% (n=1) evening, p Conclusions It has been shown that the time of day significantly affects some outcome measures of colonoscopies. Demand for colonoscopies in the UK is rising year on year, and evening lists help to meet this demand. However, it must be ensured that patient care is not compromised, and outcome measures remain stable over the course of the day.