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Evaluation of serrated lesion detection using different indicators: a single-centre, community-based, retrospective
Bernard Denis1, Vigueneche Catinat2, Laurianne Plastaras2
1Department of Gastroenterology, Hopitaux Civils de Colmar, Colmar, France bernard.denis@ch-colmar.fr.
BMJ Open Gastroenterology
|May 14, 2026
Summary
Community endoscopists showed suboptimal serrated lesion detection rates (SLDR). Longer withdrawal times during colonoscopy significantly increased adenoma detection rate (ADR) and proximal SLDR, suggesting improved quality indicators.
Area of Science:
- Gastroenterology
- Colorectal Cancer Prevention
- Endoscopic Quality Improvement
Background:
- Adenoma detection rate (ADR) and serrated lesion detection rate (SLDR) are inversely associated with postcolonoscopy colorectal cancer risk.
- Evaluating the SLDR of community endoscopists is crucial for improving colonoscopy quality.
Purpose of the Study:
- To assess the serrated lesion detection rates (SLDRs) among community-based endoscopists.
- To identify the most effective quality indicator for serrated lesion detection during colonoscopy.
Main Methods:
- Retrospective analysis of 1871 colonoscopies performed by 11 endoscopists between January 2023 and June 2024.
- Assessment of adenoma detection rate (ADR) and various serrated lesion detection rates (SLDRs), including sessile, proximal, large, clinically relevant, and advanced lesions.
Main Results:
- Overall ADR was 27.0%, sessile SLDR was 7.0%, and proximal SLDR was 8.9%.
- A significant correlation (r=0.93, p<0.001) was found between sessile and proximal SLDRs.
- Mean withdrawal times exceeding 11 minutes were associated with doubled ADR and proximal SLDR compared to times under 9 minutes.
Conclusions:
- Colonoscopist performance in detecting serrated lesions in this community setting was suboptimal.
- Increased withdrawal time during colonoscopy is linked to higher detection rates for both adenomas and serrated lesions.
- Sessile and proximal SLDRs are proposed as key quality indicators for assessing serrated lesion detection in routine colonoscopy practice.
