Trial reportClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2022
Higher Adenoma Detection Rates at Screening Associated With Lower Long-Term Colorectal Cancer Incidence and Mortality.
Trial report in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Effectiveness of sigmoidoscopy or colonoscopy screening on colorectal cancer incidence and mortality: a systematic review and meta-analysis of randomized controlled trial.Frontiers in oncology · 2024Pooled it
- Standard-definition White-light, High-definition White-light versus Narrow-band Imaging Endoscopy for Detecting Colorectal Adenomas: A Multicenter Randomized Controlled Trial.Current medical science · 2024Trial
- Colonoscopy Quality Indicators in Transition: From Adenoma Detection Rate to Serrated Lesion Detection and Beyond.Diagnostics (Basel, Switzerland) · 2026Review
- Advances in Hereditary Colorectal Cancer: How Precision Medicine Is Changing the Game.Cancers · 2025Review
- Personalizing withdrawal time by insertion time to achieve target adenoma detection rate in colonoscopy.World journal of gastroenterology · 2025Article
- Long-term colorectal cancer incidence in a post-endoscopic screening cohort, accounting for surveillance, by baseline polyp group, anatomic subsite, and sex.Journal of medical screening · 2025Article
- Texture and Color Enhanced Imaging in the Diagnosis of Colonic Neoplasia: A Systematic Review and Analysis.JGH open : an open access journal of gastroenterology and hepatology · 2025Article
- Revolutionizing gastroenterology and hepatology with artificial intelligence: From precision diagnosis to equitable healthcare through interdisciplinary practice.World journal of gastroenterology · 2025Review
- Quantifying the cost savings and health impacts of improving colonoscopy quality: an economic evaluation.BMJ quality & safety · 2025Article
- Post-colonoscopy colorectal cancer and the association with endoscopic findings in the Danish colorectal cancer screening programme.BMJ open gastroenterology · 2025Article
- Texture and color enhancement imaging versus white light imaging for the detection of colorectal adenomas: Systematic review and meta-analysis.Endoscopy international open · 2025Review
- Extended flexible sigmoidoscopy using water exchange facilitates a complete colon examination without sedation in participants undergoing average risk colorectal cancer screening: results from a randomized trial.Journal of the Canadian Association of Gastroenterology · 2024Article
- Which is the better polyp detection metric: adenomas per colonoscopy or adenoma detection rate? A simulation modeling study.Endoscopy international open · 2024Article
- Emerging Technologies in Endoscopy for Gastrointestinal Neoplasms: A Comprehensive Overview.Cureus · 2024Review
- Propofol sedation does not improve measures of colonoscopy quality but increase cost - findings from a large population-based cohort study.EClinicalMedicine · 2024Article
- A survey of current practices in post-polypectomy surveillance in Korea.Intestinal research · 2024Article
- The impact of endoscopist performance and patient factors on distal adenoma detection and colorectal cancer incidence.BMC gastroenterology · 2024Article
- Measuring the observer (Hawthorne) effect on adenoma detection rates.Endoscopy international open · 2023Article
- ENDOANGELTherapeutic advances in gastroenterology · 2023Article
- Adenoma Detection Rate in Colonoscopic Screening with Ketamine-based Sedation: A Prospective Observational Study.Medeniyet medical journal · 2022Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsDetection and removal of adenomas reduces colorectal cancer (CRC) risk. The impact of adenoma detection rates (ADRs) on long-term CRC incidence and mortality is unknown. We investigated this using data from the UK Flexible Sigmoidoscopy Screening Trial.
methodsOf 167,882 UK Flexible Sigmoidoscopy Screening Trial participants, 40,085 were in the intervention arm and underwent flexible sigmoidoscopy screening at 13 trial centers. The median follow-up time was 17 years. At each center, 1 endoscopist performed most flexible sigmoidoscopies. Multivariable logistic regression was used to classify centers into high-, intermediate-, and low-detector groups based on their main endoscopist's ADR. We calculated the incidence and mortality of distal and all-site CRC, and estimated hazard ratios (HRs) with 95% CIs using Cox regression.
resultsFive, 4, and 4 centers, respectively, were classified into the high-detector, intermediate-detector, and low-detector groups. The average ADRs in each respective group were 15%, 12%, and 9%. Distal CRC incidence and mortality were reduced among those screened compared with controls in all groups, and effects of screening varied significantly by detector ranking, with larger reductions in incidence and mortality seen in the high-detector group (incidence: HR, 0.34; 95% CI, 0.27-0.42; mortality: HR, 0.22, 95% CI, 0.13-0.37) than in the low-detector group (incidence: HR, 0.55; 95% CI, 0.44-0.68; mortality: HR, 0.54; 95% CI, 0.34-0.86). Similar results were observed for all-site CRC, with larger effects seen in the high-detector (incidence: HR, 0.58; 95% CI, 0.50-0.67; mortality: HR, 0.52; 95% CI, 0.39-0.69) than in the low-detector group (incidence: HR, 0.72; 95% CI, 0.61-0.85; mortality: HR, 0.68; 95% CI, 0.51-0.92), although the heterogeneity was not statistically significant.
conclusionsHigher ADRs at screening provide greater long-term protection against CRC incidence and mortality. Isrctn.org, number: ISRCTN28352761.
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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.