Systematic Review and Meta-Analysis Finds That 9-Minute Withdrawal Is Indeed Better Than 6 Minutes
Douglas K. Rex, MD, MASGE, reviewing Bhurwal A, et al. J Gastroenterol Hepatol 2021 Oct 7.
Very large retrospective studies of withdrawal time and colonoscopy yield have indicated that interval cancer prevention levels out with a withdrawal time of 8 to 9 minutes rather than 6 minutes. Studies have also found that improved adenoma and serrated lesion detection rates are associated with a withdrawal time of 9 minutes.
This study identified 2 randomized clinical trials, 2 cancer registries, and 3 retrospective studies, with a total of 69,551 patients, relevant to the yield of colonoscopy at 6 versus 9 minutes. The odds ratio for any adenoma detection with a withdrawal time of ≥9 minutes was increased at 1.54. The odds ratio for advanced adenoma detection with the longer time was 1.38 but did not quite reach significance. Detection of at least one sessile serrated lesion was significantly higher with an odds ratio of 1.68.
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.
Bhurwal A, Rattan P, Sarkar A, et al. A comparison of 9-min colonoscopy withdrawal time and 6-min colonoscopy withdrawal time: a systematic review and meta-analysis. J Gastroenterol Hepatol 2021 Oct 7. (Epub ahead of print) (https://doi.org/10.1111/jgh.15701)