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We read with interest the article by Adler et al (Gut 2008;57:59–64) on a prospective randomised study on narrow-band imaging (NBI) versus conventional colonoscopy for adenoma detection. Although adenomas were detected more frequently in NBI colonoscopy than in conventional colonoscopy, the difference was not statistically significant. When the two techniques were compared in consecutive subgroups of 100 study patients, adenoma detection rates in NBI colonoscopy remained fairly stable, whereas these rates steadily increased in conventional colonoscopy. They therefore speculated that the increasing adenoma detection rate in conventional colonoscopy might be caused by a training effect of better polyp …
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