ArticleGastroenterology2017
Increased Rate of Adenoma Detection Associates With Reduced Risk of Colorectal Cancer and Death.
Article in Gastroenterology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04827485 (Gluteal Squeeze for Left Colon Distension During Withdrawal in Colonoscopy), which is not on this map. Cited by 222 papers, 6 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.
Gluteal Squeeze for Left Colon Distension During Withdrawal in Colonoscopy
Who cites it
222 citing papers in PubMed, 6 syntheses or guidelines pooled it, 489 citations in OpenAlex.
- Artificial intelligence with mucosal exposure devices versus artificial intelligence alone in detection of colorectal adenomas: a systematic review and meta-analysis.Surgical endoscopy · 2026Pooled it
- One in three adenomas could be missed by white-light colonoscopy - findings from a systematic review and meta-analysis.BMC gastroenterology · 2025Pooled it
- Quality indicators for colonoscopy.Gastrointestinal endoscopy · 2024Guideline
- Recommendations for Follow-Up After Colonoscopy and Polypectomy: A Consensus Update by the US Multi-Society Task Force on Colorectal Cancer.The American journal of gastroenterology · 2020Guideline
- Effect of Endocuff use on colonoscopy outcomes: A systematic review and meta-analysis.World journal of gastroenterology · 2019Pooled it
- The contribution of endoscopy quality measures to the development of interval colorectal cancers in the screening population: a systematic review.International journal of colorectal disease · 2019Pooled it
- Trial
- Trial
- Colorectal mucosal exposure area assessment using artificial intelligence: a multicenter prospective observational study.Endoscopy · 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
- Study on the mechanism of Fuzi Lizhong decoction in the treatment of colorectal cancer of spleen kidney deficiency from the perspective of intestinal flora and hypoxia inducible factor-1α signalling pathway.Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2025Trial
- Impact of AI-aided colonoscopy in clinical practice: a prospective randomised controlled trial.BMJ open gastroenterology · 2024Trial
- Trial
- Efficacy and Safety of TJP-008 Compared to 2 L PEG with Ascorbate in Colon Cleansing: A Randomized Phase 3 Trial.Gut and liver · 2022Trial
- Trial
- Higher Adenoma Detection Rates at Screening Associated With Lower Long-Term Colorectal Cancer Incidence and Mortality.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022Trial
- Comparing right colon adenoma detection rate during water exchange and air insufflation: a double-blind randomized controlled trial.Techniques in coloproctology · 2022Trial
- Reducing adenoma miss rate of colonoscopy assisted by artificial intelligence: a multicenter randomized controlled trial.Journal of gastroenterology · 2021Trial
- The Web-Based Randomized Controlled Intervention as the Enhancer of Cancer Prevention.Medicina (Kaunas, Lithuania) · 2019Trial
- A prospective RCT comparing combined chromoendoscopy with water exchange (CWE) vs water exchange (WE) vs air insufflation (AI) in adenoma detection in screening colonoscopy.United European gastroenterology journal · 2019Trial
162 more citing papers are in PubMed but not listed here.
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Authors and funding
14 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsThe quality of endoscopists' colonoscopy performance is measured by adenoma detection rate (ADR). Although ADR is associated inversely with interval colorectal cancer and colorectal cancer death, the effects of an increasing ADR have not been shown. We investigated whether increasing ADRs from individual endoscopists is associated with reduced risks of interval colorectal cancer and subsequent death.
methodsWe performed a prospective cohort study of individuals who underwent a screening colonoscopy within the National Colorectal Cancer Screening Program in Poland, from January 1, 2004, through December 31, 2008. We collected data from 146,860 colonoscopies performed by 294 endoscopists, with each endoscopist having participated at least twice in annual editions of primary colonoscopy screening. We used annual feedback and quality benchmark indicators to improve colonoscopy performance. We used ADR quintiles in the whole data set to categorize the annual ADRs for each endoscopist. An increased ADR was defined as an increase by at least 1 quintile category, or the maintenance of the highest category in subsequent screening years. Multivariate frailty models were used to evaluate the effects of increased ADR on the risk of interval colorectal cancer and death.
resultsThroughout the enrollment period, 219 endoscopists (74.5%) increased their annual ADR category. During 895,916 person-years of follow-up evaluation through the National Cancer Registry, we identified 168 interval colorectal cancers and 44 interval cancer deaths. An increased ADR was associated with an adjusted hazard ratio for interval colorectal cancer of 0.63 (95% confidence interval [CI], 0.45-0.88; P = .006), and for cancer death of 0.50 (95% CI, 0.27-0.95; P = .035). Compared with no increase in ADR, reaching or maintaining the highest quintile ADR category (such as an ADR > 24.56%) decreased the adjusted hazard ratios for interval colorectal cancer to 0.27 (95% CI, 0.12-0.63; P = .003), and 0.18 (95% CI, 0.06-0.56; P = .003), respectively.
conclusionsIn a prospective study of individuals who underwent screening colonoscopy within a National Colorectal Cancer Screening Program, we associated increased ADR with a reduced risk of interval colorectal cancer and death.
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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.