We read with interest the article from Chung et al, 1 which suggests limited benefits in adenoma detection with narrow band imaging or flexible spectral imaging compared with standard white light examination. After a short learning curve period, there was no difference in adenoma detection even for the less experienced endoscopist. These are important results as we are increasingly inundated with new technologies or adjuncts that are hypothesised to improve adenoma detection rate (ADR). Adopting these technologies often involves high capital expenditure and a learning curve often for unsubstantiated clinical benefits.

Similarly, when high-definition colonoscopes (HDC) were introduced, they were thought to improve ADR in several retrospective studies; however, this was refuted …