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In late 2006, the New England Journal of Medicine published a landmark paper describing a wide range of adenoma detection rates among 12 experienced gastroenterologists performing screening colonoscopies in an ambulatory surgery center in Rockford, Illinois (JW Gastroenterol Jan 12 2007). One of the key predictors of detection rates was the individual gastroenterologist’s average withdrawal time. Those who averaged ≥6 minutes detected more adenomas overall — and more large adenomas specifically — than did those who averaged <6 minutes. The group instituted a quality-improvement initiative based on these findings, with a target withdrawal time of 8 minutes during screening colonoscopies (2 minutes for each segment of the colon, regardless of…