Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. May 16, 2023; 15(5): 354-367
Published online May 16, 2023. doi: 10.4253/wjge.v15.i5.354
Improving polyp detection at colonoscopy: Non-technological techniques
Ragul Rajivan, Sreedhari Thayalasekaran
Ragul Rajivan, Buckingham Medical School, Milton Keynes MK18 1EG, United Kingdom
Sreedhari Thayalasekaran, Department of Gastroenterology, University Hospitals of Leicester, Leicester LE1 5WW, United Kingdom
Author contributions: Rajivan R contributed to the acquisition and interpretation of the data, drafted and made critical revisions to the manuscript; Thayalasekaran S designed the study, made critical revisions to the manuscript and approved the final version of the manuscript to be published.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Sreedhari Thayalasekaran, MBBS, MRCP, PhD, Doctor, Department of Gastroenterology, University Hospitals of Leicester, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, United Kingdom.
Received: December 27, 2022
Peer-review started: December 27, 2022
First decision: January 22, 2023
Revised: February 3, 2023
Accepted: April 12, 2023
Article in press: April 12, 2023
Published online: May 16, 2023

Colonoscopy and polypectomy remain the gold standard investigation for the detection and prevention of colorectal cancer. Halting the progression of colonic adenoma through adequate detection of pre-cancerous lesions interrupts the progression to carcinoma. The adenoma detection rate is a key performance indicator. Increasing adenoma detection rates are associated with reducing rates of interval colorectal cancer. Endoscopists with high baseline adenoma detection rate have a meticulous technique during colonoscopy withdrawal that improves their adenoma detection. This minireview article summarizes the evidence on the following simple operator techniques and their effects on the adenoma detection rate; minimum withdrawal times, dynamic patient position change and proximal colon retroflexion.

Keywords: Colonoscopy, Minimum withdrawal times, Dynamic position change, Proximal colon retroflexion

Core Tip: Excellent endoscopists use effective mucosal exposure techniques to increase their adenoma detection rate. This minireview summarizes some of the non-technological techniques that have shown the potential to improve the adenoma detection rate.