Is Earlier Colonoscopy Better for Polyp Detection?

Some previous studies have found that the adenoma detection rate (ADR) is higher for morning versus afternoon colonoscopies and that ADRs deteriorate hourly as the work day progresses (JW Gastroenterol Apr 1 2011). However, authors who observed this phenomenon noted that it might be endoscopist dependent. Now, two new studies explore this issue.

In a retrospective analysis, Lee and colleagues assessed 1083 outpatient colonoscopies performed by 28 endoscopists and found that each elapsed hour of the day was associated with a 4.6% reduction in polyp detection (P=0.005). Also, for each increase in the number of procedures performed earlier that day by the endoscopist, polyp detection decreased by 5.4% (P=0.016). The authors contend that this la…