Disentangling true inspection time from therapeutic intervals: Validation of effective withdrawal time as a colonoscopy quality metric

doi:10.3748/wjg.121527

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Nov 7, 2026; 32(41): 121527
Published online Nov 7, 2026. doi: 10.3748/wjg.121527

Table 1 Characteristics of study patients and videos, by colonoscopy groups, n (%)/median (interquartile range)

Item	Total (n = 1044)	Therapeutic (n = 143)	Diagnostic (n = 901)	P value
Age, years	59 (46, 67)	64.0 (53, 69)	58.0 (45, 66)	< 0.001
Sex				0.004
Female	558 (53.4)	60 (42.0)	498 (55.3)
Male	486 (46.6)	83 (58.0)	403 (44.7)
Bowel preparation score	6 (5, 7)	6 (6, 7)	6 (5, 7)	0.243
Bowel preparation score group				0.073
1-3	73 (7.0)	9 (6.3)	64 (7.1)
4-6	648 (62.1)	78 (54.5)	570 (63.3)
7-9	323 (30.9)	56 (39.2)	267 (29.6)
Physician experience				0.001
Junior	325 (31.1)	25 (17.5)	300 (33.3)
Senior	719 (68.9)	118 (82.5)	601 (66.7)
Number of polyps				< 0.001
≤ 3	522 (50.0)	30 (21.0)	492 (54.6)
> 3	522 (50.0)	113 (79.0)	409 (45.4)
Biopsy rate¹	467 (44.7)	114 (79.7)	353 (39.2)	< 0.001
PDR²	749 (71.7)	143 (100)	606 (67.3)	< 0.001
ADR³	170 (36.4)	79 (69.2)	91 (25.8)	< 0.001
CRC detection rate⁴	12 (2.6)	1 (0.9)	11(3.1)	0.004
SWT (seconds)	305 (227, 444)	860 (573, 1230)	278 (219, 371)	< 0.001
Quintile 1 (Q1)	176 (88, 212)	450 (258, 539)	169 (88, 205)
Quintile 2 (Q2)	240 (212, 268)	597 (558, 730)	229 (206, 250)
Quintile 3 (Q3)	305 (268, 345)	872 (733, 971)	278 (250, 315)
Quintile 4 (Q4)	400 (346, 512)	1159 (1012, 1421)	348 (315, 398)
Quintile 5 (Q5)	836 (513, 3857)	1700 (1422, 3857)	508 (399, 2156)
EWT (seconds)	197 (143, 284)	478 (356, 764)	179 (138, 240)	< 0.001
Quintile 1 (Q1)	105 (25, 132)	246 (127, 325)	101 (25, 125)
Quintile 2 (Q2)	154 (133, 171)	378 (333, 424)	147 (125, 162)
Quintile 3 (Q3)	198 (171, 225)	480 (424, 566)	179 (162, 204)
Quintile 4 (Q4)	253 (225, 333)	660 (570, 909)	228 (204, 255)
Quintile 5 (Q5)	515 (334, 1702)	1076 (921, 1702)	338 (256, 1277)

¹Biopsy rate was defined as the proportion of patients who underwent pathological biopsy among all patients included in the study.

²Polyp detection rate was calculated as the proportion of colonoscopies in which at least one polyp was identified.

³Adenoma detection rate was calculated among cases undergoing biopsy, using the number of procedures with histologically confirmed adenomas or colorectal cancers as the numerator and the total number of procedures with biopsy as the denominator.

⁴Colorectal cancer detection rate was calculated among cases undergoing biopsy, using the number of procedures with histologically confirmed adenomas or colorectal cancers as the numerator and the total number of procedures with biopsy as the denominator.

SWT: Standard withdrawal time; ADR: Adenoma detection rate; PDR: Polyp detection rate; EWT: Effective withdrawal time; CRC: Colorectal cancer.

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Citation: Peng ZY, Li JX, Huang Y, Wang XY, An Q, Yin ZY, Li YR, Sun JY, Wang YW, Yang X, Zhang Q, Wang XM, Zhang SY, Pei ZC. Disentangling true inspection time from therapeutic intervals: Validation of effective withdrawal time as a colonoscopy quality metric. World J Gastroenterol 2026; 32(41): 121527
URL: https://www.wjgnet.com/1007-9327/full/v32/i41/121527.htm
DOI: https://dx.doi.org/10.3748/wjg.121527

Peng ZY, Li JX, Huang Y, Wang XY, An Q, Yin ZY, Li YR, Sun JY, Wang YW, Yang X, Zhang Q, Wang XM, Zhang SY, Pei ZC. Disentangling true inspection time from therapeutic intervals: Validation of effective withdrawal time as a colonoscopy quality metric. World J Gastroenterol 2026; 32(41): 121527 [DOI: 10.3748/wjg.121527]

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