Adenoma detection rate: the perfect colonoscopy quality measure or is there more?

Colonoscopy has been established as the gold standard for the screening of colorectal cancer (CRC). To help reduce the known variations in colonoscopy quality that exist from provider to provider, quality indicators have been established. Good quality indicators that have been established include the endoscopist’s adenoma detection rate (ADR), a reportable rate of the endoscopist’s ability to find adenomas, attempt of endoscopic removal of pedunculated polyps and large (<2 cm) sessile polyps prior to surgical referral, and cecal intubation.