Key factors for improving adenoma detection rate. (2nd September 2022)

• Record Type: Journal Article
• Authors: Gubbiotti, Alessandro; Spadaccini, Marco; Badalamenti, Matteo; Hassan, Cesare; Repici, Alessandro
• Is Part Of: Expert review of gastroenterology & hepatology. Volume 16:Number 9(2022)
• Page Start: 819
• Page End: 833
• Publication Date: 2022-09-02
• Subjects: Screening -- prevention -- endoscopy -- colorectal cancer -- quality; Gastroenterology -- Periodicals; Liver -- Diseases -- Periodicals; 616.3
• DOI: 10.1080/17474124.2022.2128761
• Languages: English
• ISSNs: 1747-4124

Abstract

ABSTRACT: Introduction: Colonoscopy is a fundamental tool in colorectal cancer (CRC) prevention. Nevertheless, one-fourth of colorectal neoplasms are still missed during colonoscopy, potentially being the main reason for post-colonoscopy colorectal cancer (PCCRC). Adenoma detection rate (ADR) is currently known as the best quality indicator correlating with PCCRC incidence. Areas covered: We performed a literature review in order to summarize evidences investigating key factors affecting ADR: endoscopists education and training, patient management, endoscopic techniques, improved navigation (exposition defect), and enhanced lesions recognition (vision defect) were considered. Expert opinion: 'Traditional' factors, such as split dose bowel preparation, adequate withdrawal time, and right colon second view, held a significant impact on ADR. Several devices and technologies have been developed to promote high-quality colonoscopy, however artificial intelligence may be considered the most promising tool for ADR improvement, provided that endoscopists education and recording are guaranteed.