To the Editor Sarvepalli et al1 found that during colorectal cancer screening, most of the differences in adenoma detection rate between endoscopists disappeared when adjusting for patient and colonoscopy characteristics. Adenoma detection rate should have been the quality metric for programs of colorectal cancer screening long ago.2 This is not yet the case, despite colonoscopy having been endorsed in the United States as the preferred strategy for colorectal cancer screening as early as 2000. One team even published arbitrary and very different distributions of values from one report to another one.3 The steering committee of the World Endoscopy Organization just issued a consensus statement regarding quality of colonoscopy but failed to reach a consensus for adenoma detection rate.4
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Braillon A. Patient Characteristics and Adenoma Detection Rates. JAMA Surg. 2019;154(12):1170–1171. doi:10.1001/jamasurg.2019.3375
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