A large cohort study shows that higher detection of sessile serrated lesions (SSLs)—often subtle and historically underrecognized polyps—is associated with significantly lower rates of postcolonoscopy colorectal cancer and mortality.
For years, adenoma detection rate (ADR) has been the cornerstone of colonoscopy quality. But this study reinforces that ADR alone may miss a critical pathway to cancer, particularly in the proximal colon, where serrated lesions play a larger role. Detecting these flat, easily overlooked lesions appears to reflect not just technical skill—but overall exam quality.