Association of the proximal serrated polyp detection rate of endoscopists and the incidence of postcolonoscopy colorectal cancer

Colonoscopy is the best method for the detection and thus preventing colorectal cancer. Nevertheless, CRC also occurs in patients who have received a complete colonoscopy in which all detected polyps were removed followed by an interval adjusted surveillance colonoscopy. Such cases of CRC are referred to as post-colonoscopy CRCs (PCCRCs). In 2010, Kaminski et al showed the importance of the adenoma detection rate (ADR) as a quality parameter for colonoscopy to be strongly associated with the 5-year incidence of PCCRC.
Over the last decades, however, there has been a great paradigm shift in the theories of the CRC development. It is now clear that not only conventional adenomas are precursor lesions of CRC but also serrated polyps (SPs) are accounting for up to 30% of the CRCs in total. Moreover, there are different findings that suggest that the serrated neoplasia pathway is represented in the development of PCCRC. That would suggest that endoscopist with a higher detection rate of SPs miss fewer SPs and have a lower risk of developing PCCRC.

By increasing endoscopist's proximal serrated polyp detection rate (PSPDR) it will lower the incidence of postcolonoscopy colorectal carcinoma (PCCRC).

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