Detection Measures for Colonoscopy: Considerations on the Adenoma Detection Rate, Recommended Detection Thresholds, Withdrawal Times, and Potential Updates to Measures

Douglas K. Rex

Research output: Contribution to journalReview article

Abstract

The adenoma detection rate (ADR) was first proposed by the US Multi-Society Task Force on Colorectal Cancer in 2002 and, subsequently, has been validated as a strong predictor of colorectal cancer risk after colonoscopy. ADR is now widely considered the most important quality measure in colonoscopy. ADR is a surrogate for missed lesions and for cancer incidence after colonoscopy. ADR has weaknesses, and multiple other detection targets have been evaluated as alternatives. This review discusses the history of ADR, the strength and weaknesses of ADR, and proposed alternatives to ADR. Of the alternatives, adenomas per colonoscopy has the most advantages with limited disadvantages relative to ADR and has some potential to eventually replace ADR.

Original languageEnglish (US)
Pages (from-to)130-135
Number of pages6
JournalJournal of Clinical Gastroenterology
Volume54
Issue number2
DOIs
StatePublished - Feb 1 2020

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Colonoscopy
Adenoma
Colorectal Neoplasms
Advisory Committees
History
Incidence

Keywords

  • adenoma
  • adenoma detection rate
  • colonoscopy
  • colorectal polyp

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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abstract = "The adenoma detection rate (ADR) was first proposed by the US Multi-Society Task Force on Colorectal Cancer in 2002 and, subsequently, has been validated as a strong predictor of colorectal cancer risk after colonoscopy. ADR is now widely considered the most important quality measure in colonoscopy. ADR is a surrogate for missed lesions and for cancer incidence after colonoscopy. ADR has weaknesses, and multiple other detection targets have been evaluated as alternatives. This review discusses the history of ADR, the strength and weaknesses of ADR, and proposed alternatives to ADR. Of the alternatives, adenomas per colonoscopy has the most advantages with limited disadvantages relative to ADR and has some potential to eventually replace ADR.",
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