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The principal quality indicator for colonoscopy is now the adenoma detection rate (ADR), defined as the percentage of persons aged ≥50 years undergoing their first screening colonoscopy who have one or more adenomas detected. Arguably, detection of advanced adenomas would be a better indicator because of its higher associated risk for cancer.
To test this hypothesis, a single group of 14 colonoscopists performed 1944 initial screening colonoscopies and described their ADRs and detection rates for advanced adenomas (size ≥10 mm or presence of villous elements or high-grade dysplasia). Endoscopic oversizing of advanced adenomas was assessed; for polyps resected in one piece, if histological measurement was <10 mm, the adenoma was reclassified …