Relationship between the endoscopic withdrawal time and adenoma/polyp detection rate in individual colonic segments: a KASID multicenter study

Published:September 26, 2018DOI:

      Background and Aims

      Appropriate colonoscopy withdrawal times for individual colonic segments are not well known. The relationship between withdrawal time and adenoma detection rate (ADR)/polyp detection rate (PDR) in individual colonic segments was examined in this study.


      This was a prospective observational study involving 724 patients who underwent colonoscopy screening or surveillance colonoscopy from October 2015 to February 2017 at 10 university hospitals.


      In the right side of the colon, the ADR (33.2% vs 13.7%, P < .001), PDR, serrated polyp detection rate, and number of adenomas per colonoscopy (APC) were significantly higher when the colonoscopy withdrawal time was ≥2 minutes compared with <2 minutes. When the withdrawal time was ≥4 minutes in the proximal colon and ≥3 minutes in the left segment of the colon, the ADR, PDR, and APC were significantly higher compared with withdrawal times of <4 minutes and <3 minutes, respectively. Multivariate analyses showed that the ADR was significantly associated with withdrawal times of ≥2 minutes in the right side of the colon (odds ratio [OR], 2.98; 95% confidence interval [CI], 1.72-5.15; P < .001), ≥4 minutes in the proximal colon (OR, 4.48; 95% CI, 3.15-6.36; P < .001), and ≥3 minutes in the left segment of the colon (OR, 2.92; 95% CI, 1.74-4.91; P < .001).


      The PDR and ADR appeared to be significantly increased when the withdrawal time was ≥2 minutes in the right-sided colon segment, ≥4 minutes in the proximal colon, and ≥3 minutes in the left-sided colon segment compared with shorter withdrawal times.


      ADR (adenoma detection rate), APC (adenomas per colonoscopy), CI (confidence interval), CRC (colorectal cancer), OR (odds ratio), P/L ratio (withdrawal time ratio of the proximal to left-sided colon), PDR (polyp detection rate), SDR (serrated polyp detection rate)
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