Penz D, Ferlitsch A, Waldmann E, et al. - A total of 218,193 screening colonoscopies done between 2007 and 2010 by 262 endoscopists within the Austrian quality assurance program were investigated in order to determine the influence of adenoma detection rate (ADR) on the discovery of advanced adenomas (AAs) as well as adverse event rates. Overall, a notable association between ADR and advanced ADRs (AADRs) was seen. When ADR was classified into quintiles, the mean AADR rose with rising ADR. Even in the highest ADR group, an additional rise in AADR with a mean of 10.75% was noted. Significantly, NAADRs grew continuously with betterment in ADRs although it never separated from a concurrent betterment in AADRs. Nonetheless, an important relationship of ADRs and endoscopic adverse events was also discovered, even when the perforation rate of .028% in the highest ADR group still lingered within the accepted limits on the basis of the guidelines. In summary, rising ADR is related to the improved discovery of AAs and hence is inclined to prevent more cases of colorectal cancer. Nonetheless, higher ADR was also correlated with a greater rate of adverse events, however, the adverse event rate was low.