Ensuring that endoscopists completely clear the colon of adenomas: Perhaps we try more carrots?

Colorectal cancer (CRC) screening with colonoscopy reduces the risk for CRC through the detection and removal of polyps including adenomas. However, colonoscopy is not a perfect test, as demonstrated by postcolonoscopy CRC (PCCRC).1,2 Thorough detection and complete resection of all adenomas will decrease the rate of these tumors. Measuring the success of colonoscopic clearance of adenomas can be difficult because the frequency of PCCRC is too low to make it an adequate outcome. The adenoma detection rate (ADR) was proposed almost 2 decades ago to serve as a surrogate quality indicator for colonoscopies.

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