ArticleThe New England journal of medicine2014
Adenoma detection rate and risk of colorectal cancer and death.
Article in The New England journal of medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 17 registered trials, which are not on this map. Cited by 883 papers, 12 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Prospective Randomized Comparison of the Adenoma Detection Rate in Screening Colonoscopy With and Without a Disposable Cap (ENDOCUFF VISION®)
Adenoma Detection Rate With ARC Endocuff Vision Assisted Colonoscopy vs. Standard Colonoscopy in Colorectal Cancer Screening: a Multicenter Randomized Italian Study
Use of AmplifEYE-assisted Colonoscopy Compared to Standard Colonoscopy in Polyp and Adenoma Detection
Computer Aided Detection of Polyps in the Colon
AIDA: A Multicenter, Prospective, Randomized Controlled Trial to Evaluate the Clinical Efficacy and Safety of Artificial Intelligence (AI) Detection of Adenomas (AIDA) With Standard High Definition With Light in Screening Colonoscopy
Artificial Intelligence in the Characterization of Small and Diminutive Colorectal Polyps: A Prospective Study in a Clinical Setting Using CAD EYE®
Gluteal Squeeze for Left Colon Distension During Withdrawal in Colonoscopy
Prospective Randomized Study on the Use of Artificial Intelligence (Fujifilm) for Polyp Detection in Colonoscopy
Real-World Validation of an Artificial Intelligence Characterization Support (CADx) System for Prediction of Polyp Histology in Colonoscopy: A Prospective Multicentre Study
Impact of Artificial Intelligence on Trainee Adenoma Detection Rate
PolyDeep Advance 2: Clinical Validation of PolyDeep. Randomized Clinical Trial with a Tandem Colonoscopy Design.
PolyDeep Advance 3: Randomized Clinical Trial Comparing High Definition Colonoscopy With PolyDeep Assisted High Definition Colonoscopy.
Polydeep Advance I: Prospective Diagnostic Tests Trial with a Paired Study Design
Real-time Computer-aided Polyp/Adenoma Detection During Screening Colonoscopy: a Single-center Crossover Trial
The Implementation of Computer-aided Detection in an Initial Endoscopy Training Improves the Quality Measures of Trainees' Future Colonoscopies
Artificial Intelligence in Endoscopic Diagnosis of Colorectal Polyps: A Prospective Randomized Study.
A Patient Blinded, Randomized, Controlled Trial Comparing Right Colon Adenoma Detection Rate in Colonoscopy Using Right Colon Water Exchange and Traditional Air Insufflation
Who cites it
883 citing papers in PubMed, 12 syntheses or guidelines pooled it, 2,177 citations in OpenAlex.
- Comparative Efficacy of Different AI Systems for Polyp Detection by Size During Colonoscopy: Systematic Review and Network Meta-Analysis.Journal of medical Internet research · 2026Pooled it
- Effectiveness of artificial intelligence-assisted colonoscopy for colorectal lesion detection: a systematic review and meta-analysis of randomized controlled trials.BMC medical imaging · 2026Pooled it
- Comparative Performance of Artificial Intelligence-Based Computer-Aided Detection Systems for Colorectal Polyps: A Systematic Review and Network Meta-Analysis.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026Pooled it
- Artificial intelligence-based computer-aided detection systems for adenomas during colonoscopy: a systematic review and Bayesian network meta-analysis.Frontiers in artificial intelligence · 2026Pooled it
- Linaclotide combined with polyethylene glycol for bowel preparation in colonoscopy: a systematic review and meta-analysis of randomized controlled trials.Surgical endoscopy · 2026Pooled it
- Computer-aided detection with or without mucosal-exposure devices in colonoscopy: a systematic review and meta-analysis with trial sequential analysis.Surgical endoscopy · 2026Pooled it
- Improving Colorectal Cancer Detection with AI-Assisted Colonoscopy: A Systematic Review and Meta-Analysis of 38 RCTs with GRADE Assessment.Journal of gastrointestinal cancer · 2025Pooled it
- Effectiveness of artificial intelligence-assisted colonoscopy in detecting and diagnosing colorectal tumors: a systematic review and network meta-analysis.International journal of colorectal disease · 2025Pooled it
- Linked color imaging versus conventional white-light colonoscopy for the detection of colorectal polyps.The Cochrane database of systematic reviews · 2025Pooled it
- Combined linaclotide and polyethylene glycol electrolyte for colonoscopy preparation: a network meta-analysis of 14 randomized controlled trials.International journal of colorectal disease · 2025Pooled it
- AGA Living Clinical Practice Guideline on Computer-Aided Detection-Assisted Colonoscopy.Gastroenterology · 2025Guideline
- [Efficacy of Second Forward-View Colonoscopy to Improve Adenoma Detection of Right-Side Colon: Systematic Review and Meta-Analysis].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2024Pooled it
- Trial
- Trial
- Spectral focused imaging enables enhanced colorectal adenoma detection: a multicenter, parallel randomized controlled trial.BMC medicine · 2026Trial
- A prospective study evaluating an artificial intelligence-based system for withdrawal time measurement.Endoscopy · 2026Trial
- Computer-Assisted Colonoscopy in High-Adenoma Detection Rate Settings in a High-Risk Population: A Randomized Clinical Trial.JAMA network open · 2026Trial
- Efficacy and safety of a novel sodium picosulfate oral tablet in a randomized controlled trial for bowel preparation.World journal of gastroenterology · 2026Trial
- Clinical Efficacy of Real-Time Artificial Intelligence-Assisted Colonoscopy in Colorectal Polyp Detection: A Prospective Multicenter Randomized Controlled Trial.Gut and liver · 2026Trial
- Evaluation efficacy and accuracy of a real-time computer-aided polyp detection system during colonoscopy: a prospective, multicentric, randomized, parallel-controlled study trial.Surgical endoscopy · 2025Trial
823 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
14 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThe proportion of screening colonoscopic examinations performed by a physician that detect one or more adenomas (the adenoma detection rate) is a recommended quality measure. However, little is known about the association between this rate and patients' risks of a subsequent colorectal cancer (interval cancer) and death.
methodsUsing data from an integrated health care delivery organization, we evaluated the associations between the adenoma detection rate and the risks of colorectal cancer diagnosed 6 months to 10 years after colonoscopy and of cancer-related death. With the use of Cox regression, our estimates of attributable risk were adjusted for the demographic characteristics of the patients, indications for colonoscopy, and coexisting conditions.
resultsWe evaluated 314,872 colonoscopies performed by 136 gastroenterologists; the adenoma detection rates ranged from 7.4 to 52.5%. During the follow-up period, we identified 712 interval colorectal adenocarcinomas, including 255 advanced-stage cancers, and 147 deaths from interval colorectal cancer. The unadjusted risks of interval cancer according to quintiles of adenoma detection rates, from lowest to highest, were 9.8, 8.6, 8.0, 7.0, and 4.8 cases per 10,000 person-years of follow-up, respectively. Among patients of physicians with adenoma detection rates in the highest quintile, as compared with patients of physicians with detection rates in the lowest quintile, the adjusted hazard ratio for any interval cancer was 0.52 (95% confidence interval [CI], 0.39 to 0.69), for advanced-stage interval cancer, 0.43 (95% CI, 0.29 to 0.64), and for fatal interval cancer, 0.38 (95% CI, 0.22 to 0.65). Each 1.0% increase in the adenoma detection rate was associated with a 3.0% decrease in the risk of cancer (hazard ratio, 0.97; 95% CI, 0.96 to 0.98).
conclusionsThe adenoma detection rate was inversely associated with the risks of interval colorectal cancer, advanced-stage interval cancer, and fatal interval cancer. (Funded by the Kaiser Permanente Community Benefit program and the National Cancer Institute.).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.