One in three adenomas could be missed by white-light colonoscopy – findings from a systematic review and meta-analysis

Jahn, Beate; Bundo, Marvin; Arvandi, Marjan; Schaffner, Monika; Todorovic, Jovan; Sroczynski, Gaby; Knudsen, Amy; Fischer, Timo; Schiller-Fruehwirth, Irmgard; Öfner, Dietmar; Renner, Friedrich; Jonas, Michael; Kuchin, Igor; Kruse, Julia; Santamaria, Júlia; Ferlitsch, Monika; Siebert, Uwe

doi:10.1186/s12876-025-03679-4

Table 1 Main characteristics of studies included in the systematic review and meta-analysis

From: One in three adenomas could be missed by white-light colonoscopy – findings from a systematic review and meta-analysis

	Matsuda 2008 [47]	Hewett 2010 [37]	Leufkens 2011 [38]	Ikematsu 2012 [17]	Gralnek 2014 [36]	Dik 2015 [5]	Halpern 2015 [39]	Min 2017 [26]	Papanikolaou 2017 [40]	Triantafyllou 2017 [41]	De Palma 2018 [42]	Riu Pons 2020 [35]	Wang 2020 [43]	Kamba 2021 [44]	Glissen Brown 2022 [45]	Wallace 2022 [46]
Country	J	USA	USA, NL, I, B, UK	J	NL, USA, IL	NL, USA, IL	IL, D	China	GR	GR	I	Spain	China	J	USA	I, UK, USA
Type of NCT	IE-CT	BF-CT	BF-CT	IE-CT	BF-CT	BF-CT	BF-CT	IE-CT	BF-CT	BF-CT	BF-CT	IE-CT	CADe	CADe	CADe	CADe
Total randomized, n	167	100	448	813	197	126	126	152	220	200	288	41	382	358	234	249
NCT-WLC randomized, n	83	52	226	406	101	62	66	77	110	100	144	21	192	179	116	116
NCT-WLC included, n	83	52	176	389	97	57	52	71	107	100	137	21	184	171	113	109
WLC-NCT randomized, n	84	48	222	407	96	64	60	75	110	100	144	20	190	179	116	114
WLC-NCT included, n	84	48	173	393	88	59	54	70	108	100	137	20	185	173	110	104
Age NCT-WLC	62 ± 10^a	61 (1)^b	58 (23–79)^C	63 (10)^b	57 (21–70)^c	58 ± 9^a	58 ± 8^a	46 ± 13^c	62 (10)^b	61 (10)^b	55 ± 13^a	60^d	48 ± 10.82^a	61 ± 9.89^a	61 ± 9.83^a	63 ± 8.2^a
Age WLC-NCT	62 ± 9.5^a	63 (1.2)^b	57 (26–83)^c	63 (9.9)^b	56 (22–70)^c	60 ± 9.3^a	55 ± 7.9^a	48 ± 13.1^c	64 (9.5)^b	61 (9.6)^b	56 ± 12.3^a	59^d	47 ± 10.38^a	61 ± 10.01^a	61 ± 8.45^a	65 ± 8.1^a
Females NCT-WLC, n (%)	25 (30)	24 (46)	54 (31)	122 (31)	55 (57)	16 (28)	31 (60)	34 (48)	61 (56)	46 (46)	66 (48)	8 (39)	91 (49)	42 (24)	59 (52)	36 (31)
Females WLC-NCT, n (%)	35 (42)	19 (40)	63 (36)	116 (30)	46 (52)	29 (49)	29 (54)	32 (46)	58 (52)	48 (48)	65 (47)	11 (55)	99 (54)	41 (23)	42 (38)	37 (32)
∅ adenoma. NCT- WLC	0.80	2.02	0.77	1.00	0.61	1.18	0.77	NR	0.68	1.09	0.64	1.57	0.78	1.42	1.50	2.12
∅ adenoma. WLC-NCT	1.13	2.77	0.86	1.09	0.56	0.98	0.70	NR	0.74	0.86	0.74	1.20	0.65	1.25	1.31	2.17
Colon examined	RC	WC	WC	RC	WC	WC	WC	WC	WC	WC	WC	WC	WC	WC	WC	WC
Setting	NR	A	A, non A	A	A, non A	A, non A	A, non A	A, non A	A, non A	A, non A	A	non A	non A	A, non A	A	A, non A
Single/multi center	Single	Single	Multi	Multi	Multi	Multi	Multi	Multi	Multi	Multi	Single	Single	Single	Multi	Multi	Multi
Type tandem study	Type I	Type I	Type I	Type I	Type I	Type I	Type I	Type II	Type I	Type I	Type II	Type I	Type I	Type I	Type I	Type I
Endoscopists, n	1	2	15	27	15	6	> 1	> 1	5	6	4	5	3	32	> 1	> 1
Diff. endoscopist 2nd	No	No	No	No	No	No	No	Yes	No	No	No	No	No	No	No	No
Endoscopist blinded alloc.	NR	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	NR	Yes	Yes	Yes	Yes	Yes	Yes

Legend: ∅ adenoma. – average number of adenomas detected per study group, A – academic, alloc. – allocation, B – Belgium, BF-CT – behind-folds visualizing colonoscopic technologies, diff. – different, CADe – computer aided diagnosis endoscopy, GR – Grece, I – Italy, IE-CT – image-enhancement colonoscopic technologies, IL – Israel, J – Japan, NCT – novel colonoscopic technologies, NR – not reported, NL – Netherlands, RC – right colon, UK – United Kingdom, USA – United States of America, WC – whole colon, WLC – white light colonoscopy. (a) indicates standard deviation, (b) indicates standard error, (c) indicates range, (d) indicates that no measure of variability is available

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