Adenoma detection rate and risk of interval postcolonoscopy colorectal cancer in fecal immunochemical test-based screening

The adenoma detection rate (ADR) is an important quality indicator for endocopists performing colonoscopies for colorectal cancer (SRC) screening, as it is associated with postcolonoscopy CRCs (PCCRCs). Data on ADRs of endoscopists performing colonoscopies in FIT-based screening are scarce. A population-based cohort study in The Netherlands found that the ADR of endoscopists was inversely associated with the risk of interval PCCRC in FIT-positive patients. For every 1000 patients undergoing coloscopy, the expected number of interval PCCRC diagnoses after five years was 2 for endoscopists with ADR of 70%; compared with more than 2.5, almost 3.5, and more than 4.5 for endoscopists with ADRs of 65%, 60%, and 55%, respectively. The authors conclude that endoscopists performing colonoscopy in FIT-based screening should aim for markedly higher ADRs compared with primary colonoscopy.