Seek and ye shall find—maybe ▸

The authors first studied 684 patients undergoing total colonoscopy (with chromoendoscopy) twice within 30 days to calculate odds ratios of missing neoplastic polyps and the relative risk for developing new adenomas with surveillance colonoscopy. Results were compared with the number and location of polyps found at index colonoscopy. Despite meticulous technique using high quality colonoscopes, 13.9% of adenomatous polyps were missed in 22.8% of patients. No cancers were missed but, not surprisingly, flat/superficial polyps ⩽5 mm in size were most commonly missed and more so in the right colon. The odds ratio for finding polyps at the second procedure in patients with two or more polyps at the first examination was two compared with those with a normal colonoscopy.

Secondly, they examined 864 patients who had additionally undergone multiple examinations over a 10 year period for polyp surveillance to calculate the cumulative incidence rates for adenoma development. The time intervals …