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The impact of suboptimal bowel preparation on adenoma miss rates and the factors associated with early repeat colonoscopy

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Lebwohl, Benjamin, Kastrinos, Fay, Glick, Michael, Rosenbaum, Adam J., Wang, Timothy, Neugut, Alfred I.·2011·Gastrointestinal Endoscopy

Abstract

Background There are no guidelines for the recommended interval to the next examination after colonoscopy with suboptimal bowel preparation. Aims To identify factors associated with early repeat colonoscopy after initial examinations with suboptimal preparations, and to measure adenoma miss rates in this context. Methods We analyzed all colonoscopies over 3 years at a single, hospital-based endoscopy unit. We defined early repeat colonoscopies after a suboptimal preparation as those occurring <3 years after the index examination. Adenoma miss rates were calculated by dividing the number of lesions found on the second colonoscopy by the total on both examinations. Results Of 12,787 colonoscopies, preparation quality was suboptimal (poor or fair) in 3,047 (24%) patients. Among these 3,047 patients, repeat examination was performed in <3 years in 505 (17%). Factors associated with early repeat included lack of cecal intubation (OR 3.62, 95%CI 2.50–5.24) and finding a polyp (OR 1.55, 95%CI 1.17–2.07). Among 216 repeat colonoscopies with an optimal preparation, 198 adenomas were identified, of which 83 were only seen on the second examination, an adenoma miss rate of 42% (95%CI 35–49). The advanced adenoma miss rate was 27% (95%CI 17–41). For colonoscopies repeated in <1 year, the adenoma and advanced adenoma miss rates were 35% and 36% respectively. Limitations Single-center, retrospective study. Conclusions While a minority of patients undergo early repeat examination after a suboptimally prepared colonoscopy, the miss rates for suboptimally prepared colonoscopies were high, suggesting that suboptimal bowel preparation substantially decreases colonoscopy effectiveness, and may mandate an early follow-up examination.

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Metadata

Authors
Lebwohl, B., Kastrinos, F., Glick, M., Rosenbaum, A. J., Wang, T., & Neugut, A. I.
Venue
Gastrointestinal Endoscopy
Publisher
Elsevier BV
Published
2011-06
Volume
73
Issue
6
Pages
1207-1214
ISSN
0016-5107 (ISSN-L)
OpenAlex
W2123845707
Cited by
466
References
19
FWCI
15.44
Type
journal article
Language
en
Open access
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CoChat. (2026). Citation check: The impact of suboptimal bowel preparation on adenoma miss rates and the factors associated with early repeat colonoscopy. https://app.cochat.ai/papers/10.1016/j.gie.2011.01.051
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Lebwohl, B., Kastrinos, F., Glick, M., Rosenbaum, A. J., Wang, T., & Neugut, A. I. (2011). The impact of suboptimal bowel preparation on adenoma miss rates and the factors associated with early repeat colonoscopy. Gastrointestinal Endoscopy. https://doi.org/10.1016/j.gie.2011.01.051

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