Free Online 30-Minute Interactive Training Improves ADR and Lowers Interval Cancer Risk

Free Online 30-Minute Interactive Training Improves ADR and Lowers Interval Cancer Risk

Douglas K. Rex, MD, MASGE, reviewing Corley DA, et al. Gastrointest Endosc 2023 Apr 22.

This study from the Northern California Kaiser Permanente health care system evaluated the impact of a 30-minute online interactive training program collaboratively developed by endoscopists, endoscopy unit staff, psychologists, and researchers with expertise in behavioral change theory and evidence-based interventions.

In the study conducted in late 2014, 86 endoscopists underwent the new training program. All participating endoscopists completed at least 100 colonoscopies annually for the 3 years before and after the training. 

There was an immediate 3.13% increase in the adenoma detection rate (ADR) during the quarter after training. By comparison, ADRs increased by an absolute 0.58% per quarter in the 3 years before training and 0.33% per quarter in the 3 years after. Endoscopists with a pretraining ADR lower than the median ADR of 29% experienced a greater increase in ADR immediately after training, with an absolute mean increase of 4.9%. For each 1% ADR increase, there was a 4% reduction in postcolonoscopy colorectal cancer (PCCRC) risk. Endoscopists with an ADR increase ≥10% produced a 55% lower risk of PCCRC in their patients than endoscopists with an absolute ADR change <1%.

Douglas K. Rex, MD, FASGE


This is a significant advance in the science and practice of ADR improvement because the program is available to everyone for free here. I suspect many high-detecting endoscopists are already familiar with most of the concepts presented in the program, but that many low-detecting endoscopists will not be. Endoscopy unit leaders and individual endoscopists should take advantage of the program and consider mandating it for endoscopists with lower ADRs.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.


Corley DA, Jensen CD, Lee JK, et al. Impact of a scalable training program on the quality of colonoscopy performance and risk of post-colonoscopy colorectal cancer. Gastrointest Endosc 2023 Apr 22. (Epub ahead of print) (

Nach oben scrollen