The efficacy of endoscopic screening for colorectal neoplasia is strongly influenced by adequacy of the preparation and the quality of the exam. Past studies have emphasized the association of diminished polyp detection with overly fast withdrawal from the cecum. In this issue of the journal, Chen and Rex present data more directly associating differences in the rate of polyp detection with the individual endoscopist, demonstrating that some do a better job than others. Why this is so is unclear. Further data are needed regarding the causes and means to reduction of inter-endoscopist differences. Few units report and few endoscopists actually know their personal rates for polyp detection. As with cecal intubation rates and withdrawal times, provision of personal and group data would undoubtedly enhance performance.
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