Maximizing Detection During Colonoscopy

The fundamental purpose of most colonoscopies is prevention of colorectal cancer (CRC), and CRC prevention starts with high-level detection. Every colonoscopist should measure and strive for the highest level of detection. The essentials of high-level detection are detailed knowledge of the appearance of subtle precancerous lesions combined with excellent bowel preparation, high definition colonoscopy, and measurement and reporting of adenoma detection rate. These fundamentals must be combined with a highly effective and compulsive basic examination technique. This article reviews new recommendations on performance of high-quality colonoscopy, obstacles to detection, and tools and techniques to help improve visualization and lesion detection.