Factors influencing the miss rate of polyps in a back-to-back colonoscopy study
Abstract
Background and study aims In patients undergoing colonoscopy, 22 % - 28 % of polyps and 20 % - 24 % of adenomas are missed. It is unclear which factors contribute to polyp miss rates, but colorectal cancer detected within 3 years after colonoscopy may originate from missed lesions. The aim of the current study was to determine patient- and polyp-related factors that influence the miss rates of polyps and adenomas during colonoscopy. Patients and methods Data from 406 patients were obtained from a multicenter, randomized back-to-back colonoscopy study investigating the Third Eye Retroscope (TER) in improving polyp detection rate by visualizing hidden areas such as folds and curves. Patients were randomized to undergo standard colonoscopy followed by colonoscopy with TER, or vice versa. Miss rates were calculated for all polyps and adenomas. All lesions were categorized for size and location within the colon/rectum. Odds ratios (ORs) were computed using adjusted logistic regression models to identify factors independently associated with missed lesions. Results The miss rate was 25 % (150 /611) for all polyps and 26 % (90 /350) for adenomas. Miss rates were significantly lower (21 % vs. 29 %) in patients randomized to TER as the first procedure (P 2 polyps compared with ≤ 2 polyps detected during the first colonoscopy increased the risk of missing additional polyps (adjusted OR = 2.83; 95 % confidence interval [CI] 1.22 - 6.70). Adenomas in the left colon compared with adenomas…
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Over-alternation bias may contribute to observed increase in misses following detecting the first polyp during a colonoscopy.
“This tendency may contribute to the observed increase in misses following detecting the first polyp during a colonoscopy [7 , 27-29] .”
From Enhancing human-AI collaboration: The case of colonoscopy (2024) · cites this paper as [27]
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- Authors
- Leufkens, A., van Oijen, M., Vleggaar, F., & Siersema, P.
- Affiliations
- University Medical Center Utrecht (NL)
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
- Venue
- Endoscopy
- Publisher
- Georg Thieme Verlag KG
- Published
- 2012-03-22
- Volume
- 44
- Issue
- 05
- Pages
- 470-475
- ISSN
- 0013-726X (ISSN-L)
- 1438-8812
- OpenAlex
- W2320150036
- Cited by
- 375
- References
- 0
- Citations by year
- 2026: 24 · 2025: 35 · 2024: 39 · 2023: 42 · 2022: 37 · 2021: 39 · 2020: 32 · 2019: 34 · 2018: 16 · 2017: 19 · 2016: 14 · 2015: 20 · 2014: 16 · 2013: 6
- FWCI
- 6.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Endoscopy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
- Health Sciences › Medicine › Pathology and Forensic Medicine › Genetic factors in colorectal cancer
- Health Sciences › Medicine › Oncology › Colorectal Cancer Surgical Treatments
- Keywords
- missed polyps, colonoscopy, colorectal adenoma, polyp detection rate, polyp location, colorectal cancer prevention
- MeSH terms
- Adenoma, Aged, Colonic Neoplasms, Colonic Polyps, Colonoscopy, Diagnostic Errors, False Negative Reactions, Female, Humans, Male, Middle Aged
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