Korean J Gastrointest Endosc.  2003 Apr;26(4):199-204.

Colonoscopic Miss-rate of Colorectal Polyp and Adenoma

• Choi KY
• Lee BI
• Lee SY
• Lee WC
• Bae SS
• Kim BW
• Choi H
• Cho SH
• Park SH
• Chae HS
• Choi MG
• Chung IS
• Cha SB

Abstract

BACKGROUND/AIMS
While colonoscopy is the gold standard diagnostic test for the detection of colorectal polyps (especially adenomas), it is also an imperfect method. We prospectively estimated the colonoscopic miss-rate of colorectal polyp and adenoma.
METHODS
We performed polypectomies in 603 out of 2,006 patients over age of 40 who underwent their first time colonoscopy between September 1999 and June 2001. A follow-up colonoscopy was performed within 60 days in 235 (53.4%) among 440 enrolled patients.
RESULTS
Seventy-three (31.0%) of 235 patients with polyps on initial colonoscopy were missed polyps and 37 (23.2%) of 159 patients with adenomas on initial colonoscopy were missed adenomas. As the number of polyps on the initial examination increased, the miss-rate increased significantly (p=0.01). The most frequent size of missed polyp was 3~4 mm (55.5%, p=0.00) and the most frequent location was sigmoid colon (27.3%, p=0.00).
CONCLUSION
It may be a fallacy to declare that all colorectal polyps are removed just after one session of colonoscopy. Examiners should make every effort to reduce the miss-rate of colorectal polyps during colonoscopy.

Keyword

Colorectal polyp; Colorectal adenoma; Colonoscopy; Miss-rate

MeSH Terms

Adenoma*
Colon, Sigmoid
Colonoscopy
Diagnostic Tests, Routine
Follow-Up Studies
Humans
Polyps*
Prospective Studies