Kligman E, et al. - Authors undertook a comparison of the conventional adenoma detection rate (ADR) to the ADR of colonoscopies performed for the investigation of positive fecal immunochemical test (FIT), in asymptomatic average-risk patients. The enrollment consisted of patients ≥ 50 years old who underwent colonoscopy for the evaluation of a positive FIT between January 1, 2013, and July 31, 2014, at a tertiary Veterans Affairs Medical Center. Data reported higher ADR of colonoscopies performed for the evaluation of a positive FIT compared to the ADR of screening colonoscopies. Furthermore, subjects with a positive FIT had considerably more adenomas per colonoscopy and advanced neoplasms. The quality of colonoscopies performed for a positive FIT appeared to be insufficiently assessed by the conventional ADR and warranted additional quality metrics.