# Adenoma detection rate

Source: https://onco.cc/terms/adenoma-detection-rate/  
OnCo record `adenoma-detection-rate` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The adenoma detection rate is the share of screening colonoscopies in which an endoscopist finds at least one adenoma. It is the best single measure of how good a colonoscopy service is, because the patients of endoscopists who find more polyps go on to get fewer cancers and to die of them less often.

## Summary

The measure. The adenoma detection rate is the proportion of a given endoscopist's screening colonoscopies in which one or more adenomas are found. It is a proxy for how carefully the bowel is inspected: withdrawal time, bowel preparation, technique behind folds, and willingness to remove small flat lesions all feed into it.

What it predicts. Across 314,872 colonoscopies by 136 gastroenterologists in one American health system, detection rates ranged from 7.4 to 52.5 percent. Comparing the highest to the lowest fifth, the adjusted hazard ratio was 0.52 for any interval colorectal cancer, 0.43 for advanced-stage interval cancer and 0.38 for fatal interval cancer, and every 1.0 percentage point of detection rate was worth a 3.0 percent lower risk of cancer (Corley 2014). In a Polish screening programme of 45,026 people examined by 186 endoscopists, the detection rate was the quality indicator that predicted interval cancer, and caecal intubation rate was not; endoscopists below 20 percent had roughly a tenfold higher hazard than those at or above it (Kaminski 2010).

Why it matters to a reader. A colonoscopy is not a single standardised thing, and the difference between a careful and a hurried one is measurable in cancers years later. National programmes publish detection rates and use them to set thresholds for accreditation; the serrated equivalent, the sessile serrated polyp detection rate, is newer and less standardised because those lesions are the harder ones to see.

## Fields

- Kind: Term
- Last checked: 2026-09-24
- Also known as: ADR; adenoma detection; colonoscopy quality indicator; detection rate
- Tags: gi; colorectal

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Colonoscopy
- Corley, N Engl J Med 2014: adenoma detection rate and risk of colorectal cancer and death (314,872 colonoscopies, 136 endoscopists): https://doi.org/10.1056/nejmoa1309086
- Kaminski, N Engl J Med 2010: quality indicators for colonoscopy and the risk of interval cancer (45,026 people, 186 endoscopists): https://doi.org/10.1056/nejmoa0907667
- Rutter, Gut 2020: BSG, ACPGBI and Public Health England post-polypectomy and post-resection surveillance guidelines: https://doi.org/10.1136/gutjnl-2019-319858

## Connected records

- cancers: [Colon cancer (adenocarcinoma of the colon)](https://onco.cc/cancers/colon-cancer/), [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Rectal cancer](https://onco.cc/cancers/rectal-cancer/)
- terms: [Colonoscopy](https://onco.cc/terms/colonoscopy/), [Interval cancer](https://onco.cc/terms/interval-cancer/), [Polyp types in the bowel](https://onco.cc/terms/colorectal-polyp-types/), [Serrated pathway](https://onco.cc/terms/serrated-pathway/), [Surveillance intervals after polypectomy](https://onco.cc/terms/colonoscopy-surveillance-intervals/)
- technologies: [AI polyp detection in colonoscopy](https://onco.cc/technologies/ai-endoscopy-detection/), [Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood)](https://onco.cc/technologies/colorectal-screening/)

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