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Colonoscopy is associated with a lower level of protection against right-sided (vs. left-sided) colon cancer, and one of the major contributing factors is missed lesions. A repeat examination of the right colon during colonoscopy has been proposed to mitigate the risk for missing lesions. To better assess the effect of this intervention, investigators randomized over 1000 patients undergoing colonoscopy by one of 45 endoscopists to a second forward view (after withdrawal from cecum to hepatic flexure) or standard withdrawal. The results were as follows:
The right-colon adenoma detection rate (ADR) was significantly higher in the second-look group (27% vs 22%).
Overall ADR was comparable between the two groups (49% and 45%).
The second examinat…