A U.S. survey of 351 gastroenterologists, GI fellows and surgeons, presented at DDW 2026, found that while most respondents support performing a second inspection of the right colon during colonoscopy, the practice is not consistently incorporated into institutional policy or quality measurement.
Prior evidence suggests a second right-colon inspection can increase adenoma detection by about 7%, and AGA and ACG/ASGE recommendations already support a second view using either retroflexion or forward viewing. However, the societies do not currently specify how the practice should be incorporated into quality metrics.
In the survey, 81% of respondents believed second inspection increases ADR and 72% said they performed it in more than 80% of colonoscopies. Yet only 5% worked at institutions where it was mandatory. Technical difficulty was the most frequently cited barrier (59%), followed by poor bowel preparation (53%), patient discomfort (34%) and workflow/time concerns (23%). More than half said the additional inspection takes only one or two minutes.