Lam AY, Li Y, Gregory DL, et al. - Researchers conducted a retrospective cohort study to determine interval colorectal cancer (iCRC) incidence, evaluate the association between adenoma detection rates (ADRs) and iCRC rates, and assess iCRC rates over time concomitant with initiation of an institutional colonoscopy QI program. In total, 193,939 colonoscopies were conducted over the study period. One hundred eighty-six patients with iCRC were identified. Data reported that the iCRC overall rate was 0.12% and the early iCRC rate was 0.06%. Overall iCRC rates improved from 0.15% to 0.08% and early iCRC rates improved from 0.07% to 0.04% after QI program initiation. The authors verified that iCRC rate is inversely associated with provider ADR. ADR rose and iCRC rates decreased over time, in conjunction with a QI program focusing on split-dose bowel preparation, quality metric measurement, provider education, and feedback. Measurement of iCRC rates should be regarded as a feasible, outcome-driven institutional colonoscopy quality metric.