ReviewTranslational gastroenterology and hepatology2026
The impact of sedation on adenoma and polyp detection rates in colonoscopy: an evidence-informed narrative review.
Review in Translational gastroenterology and hepatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
8 authors.
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Abstract
Background and Objective: Colorectal cancer (CRC) is one of the most prevalent cancers globally, with rising incidence and mortality rates. Early detection significantly improves survival, and colonoscopy is the gold standard for identifying and removing precancerous lesions. Sedation is commonly used to enhance patient comfort and procedural acceptance. The adenoma detection rate (ADR) and polyp detection rate (PDR) are key quality measures of colonoscopy effectiveness. This review examines whether sedation impacts these detection rates and explores differences between sedated and unsedated colonoscopy procedures. Methods: A narrative review was conducted synthesizing evidence from randomized controlled trials, meta-analyses, prospective cohort studies, and retrospective observational studies. Literature searches were performed using PubMed, Embase, and Web of Science databases for studies published up to June 2024, combining Medical Subject Headings (MeSH) terms and keywords including colonoscopy, sedation, adenoma detection rate, and polyp detection rate. Studies were selected based on clinical relevance and methodological transparency regarding sedation use, depth, or modality in relation to colonoscopy quality indicators. Key Content and Findings: Evidence regarding sedation's impact on ADR and PDR remains inconsistent. While some retrospective studies report higher detection rates with sedation-particularly for smaller and flat adenomas-others demonstrate no significant difference or even comparable outcomes in unsedated procedures. Propofol-based sedation and deeper sedation levels improve patient satisfaction and procedural completion rates but do not consistently enhance ADR or PDR across populations. Detection performance appears more strongly influenced by endoscopist experience, withdrawal technique, and inspection time than by sedation status. Confounding factors including patient selection, regional practice patterns, and study design limitations contribute to heterogeneous results. Conclusions: Sedation consistently improves patient comfort and procedural feasibility during colonoscopy, but its independent effect on ADR and PDR remains inconclusive. Moderate sedation is sufficient for most routine screening procedures. Sedation strategies should be individualized based on patient risk profiles and procedural requirements rather than routinely escalated to enhance detection performance.
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