SynthesisBMC gastroenterology2025
One in three adenomas could be missed by white-light colonoscopy - findings from a systematic review and meta-analysis.
Synthesis in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Should Multi-Cancer Early Detection Testing Replace Guideline-Recommended Colorectal Cancer Screening? A Comparative Modeling Analysis.medRxiv : the preprint server for health sciences · 2026Article
- CRC-SPIN version 3.0: an updated policy model for colorectal cancer screening that includes the serrated pathway.Journal of the National Cancer Institute · 2026Article
- Advancements and limitations of image-enhanced endoscopy in colorectal lesion diagnosis and treatment selection: A narrative review.DEN open · 2026Review
- Effect of Combination of a Mucosal Exposure Device and Computer-Aided Detection in Diagnostic, Screening, and Surveillance Colonoscopy: An International, Multicenter Study.Clinical and translational gastroenterology · 2026Article
- Endostrat: a multicenter study of AI-assisted two-level risk stratification for gastric precancerous and early neoplastic lesion screening.Frontiers in medicine · 2026Article
- Clinical Evaluation of PolyDeep, A Computer-Aided Detection System: A Multicenter Randomized Tandem Colonoscopy Trial.Diagnostics (Basel, Switzerland) · 2025Article
- Multiclassification of Colorectal Polyps from Colonoscopy Images Using AI for Early Diagnosis.Diagnostics (Basel, Switzerland) · 2025Article
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhite light (conventional) colonoscopy (WLC) is widely used for colorectal cancer screening, diagnosis and surveillance but endoscopists may fail to detect adenomas. Our goal was to assess and synthesize overall and subgroup-specific adenoma miss rates (AMR) of WLC in daily practice.
methodsWe conducted a systematic review in MEDLINE, EMBASE, Cochrane Library, and grey literature on studies evaluating diagnostic WLC accuracy in tandem studies with novel-colonoscopic technologies (NCT) in subjects undergoing screening, diagnostic or surveillance colonoscopy. Information on study design, AMR overall and specific for adenoma size, histology, location, morphology and further outcomes were extracted and reported in standardized evidence tables. Study quality was assessed using the QUADAS-2 tool. Random-effects meta-analyses and meta-regression were performed to estimate pooled estimates for AMR with 95% confidence intervals (95% CI) and to explain heterogeneity.
resultsOut of 5,963 identified studies, we included sixteen studies with 4,101 individuals in our meta-analysis. One in three adenomas (34%; 95% CI: 30-38%) was missed by WLC in daily practice individuals. Subgroup analyses showed significant AMR differences by size (36%, adenomas 1-5 mm; 27%, adenomas 6-9 mm; 12%, adenomas ≥ 10 mm), histology (non-advanced: 42%, advanced: 21%), morphology (flat: 50%, polypoid: 27%), but not by location (distal: 36%, proximal: 36%).
conclusionsBased on our meta-analysis, one in three adenomas could be missed by WLC. This may significantly contribute to interval cancers. Our results should be considered in health technology assessment when interpreting sensitivity of fecal occult blood or other screening tests derived from studies using WLC as "gold standard".
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