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The adenoma detection rate (ADR) is the prime measure of colonoscopy quality. There are few data about its effect on long-term colorectal cancer (CRC) incidence and mortality, particularly in settings that offer flexible sigmoidoscopy as a primary screening modality. To further study this issue, investigators identified over 40,000 participants in the intervention arm of the United Kingdom Flexible Sigmoidoscopy Screening Trial and determined their CRC incidence and mortality risks stratified by baseline ADR. Median follow-up was 17 years. The results were as follows:
Endoscopy centers were classified into high-, intermediate-, and low-detectors, with mean ADRs of 15%, 12%, and 9%, respectively. The rates of referral to colonoscopy ranged fr…