The big picture: Does colonoscopy work?

David G. Hewett, Douglas K. Rex

Research output: Contribution to journalReview article

11 Scopus citations


Colonoscopy for average-risk colorectal cancer screening has transformed the practice of gastrointestinal medicine in the United States. However, although the dominant screening strategy, its use is not supported by randomized controlled trials. Observational data do support a protective effect of colonoscopy and polypectomy on colorectal cancer incidence and mortality, but the level of protection in the proximal colon is variable and operator-dependent. Colonoscopy by high-level detectors remains highly effective, and ongoing quality improvement initiatives should consider regulatory factors that motivate changes in physician behavior.

Original languageEnglish (US)
Pages (from-to)403-413
Number of pages11
JournalGastrointestinal Endoscopy Clinics of North America
Issue number2
StatePublished - Apr 1 2015


  • Adenoma detection
  • Colonoscopy
  • Colorectal cancer
  • Colorectal cancer screening
  • Interval cancer

ASJC Scopus subject areas

  • Gastroenterology

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