Efficacy of Oral Sulfate Tablets for Bowel Preparation and Adenoma Detection Rate.

BACKGROUND/AIMS
The adenoma detection rate (ADR), which is closely related to bowel preparation, is the most important factor for colonoscopy quality assessment. New oral sulfate tablets (OSTs) have been developed to improve bowel preparation compliance. This study evaluated the efficacy of OSTs in terms of the ADR and bowel preparation status.


METHODS
Medical records of subjects under the age of 65 who underwent colonoscopy from Mar 2019 to Feb 2021 were retrospectively reviewed. Polyethylene glycol with ascorbic acid (PEG-A) was used as a bowel preparation for the first half of the study period, and OSTs were used for the second half. In total, 16,971 subjects were included in the study: 9,199 (54.2%) used PEG-A and 7,772 (45.8%) used OSTs. Bowel cleansing quality was assessed by the Boston Bowel Preparation Scale (BBPS).


RESULTS
The average age was 50 years. The rate of adequate bowel preparation was higher in the OST group than in the PEG-A group (97.2% vs. 95.0%, p<0.001). The mean BBPS was also higher in the OST group (8.02 vs. 7.75, p<0.001). The adenomas per colonoscopy (APC), the ADR and the sessile serrated polyp detection rate (SSPDR) were higher in the OST group than in the PEG-A group (APC 0.56 ± 1.01 vs. 0.48 ± 0.91, p<0.001; ADR 34.5% vs. 30.7%, p<0.001; SSPDR 5.2% vs. 3.3%, p<0.001).


CONCLUSIONS
Compared with PEG-A, OSTs yielded superior APC, ADRs, SSPDRs and better bowel cleanliness. Therefore, OSTs are a good alternative for patients who have difficulty taking large-volume bowel preparation formulations.