Five-Year Risk of Colorectal Neoplasia after Negative Colonoscopy

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Abstract
The rate of 1.3% for advanced adenoma detected approximately 5 years after a negative colonoscopy, is indeed low, as Imperiale et al. report (Sept. 18 issue).1 The rate for detection of any adenoma was 16.0%. What is striking is the low proportion of patients with advanced adenoma relative to the proportion of patients with any adenoma (8.1%). Numerous factors may have contributed to this low observed rate, including a low risk of this condition in the study population, low rates of detection by endoscopists, and low rates observed by pathologists.