Dressing Up an Old Friend in New Clothes: A New Approach to Measuring Adenoma Detection Rate

Post colonoscopy colorectal cancer (PCCRC) is a wellwith PCCRCs are more likely to present emergently and to die from their cancers compared with those whose cancers are detected at the initial colonoscopy.2 There are challenges in measuring PCCRCs and reporting them in a timely fashion, which limits the usefulness of PCCRC as an endoscopist quality indicator. Endoscopist adenoma detection rate (ADR) is easier to measure and report in a timely fashion and has been found to be inversely associated with PCCRC.3 However, to date, this association has been limited to ADR for primary screening colonoscopies. Although intended to facilitate comparisons across practices and jurisdictions, measuring ADR on colonoscopies done for a single indication only has proved challenging.4 For this reason, as early as 2016, the UK colonoscopy quality guidance recommended overall ADR (across all indications in people 18 years and older) be used instead.5 However, until now, there was a paucity of data to support this