Insertion time as a proxy for procedural complexity: Refining its role in predictive models of adenoma detection

doi:10.3748/wjg.v31.i47.114092

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Dec 21, 2025 (publication date) through Dec 19, 2025

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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

Letter to the Editor

World J Gastroenterol. Dec 21, 2025; 31(47): 114092
Published online Dec 21, 2025. doi: 10.3748/wjg.v31.i47.114092

Insertion time as a proxy for procedural complexity: Refining its role in predictive models of adenoma detection

Predrag Jovanovic

Predrag Jovanovic, Faculty of Medicine, Department of Internal Medicine, University of Tuzla, Tuzla 75000, Tuzla Canton, Bosnia and Herzegovina

Predrag Jovanovic, Department of Gastroenterology and Hepatology, University Clinical Center Tuzla, Tuzla 75000, Tuzla Canton, Bosnia and Herzegovina

Author contributions: Jovanovic P designed the research, performed the analysis, and wrote the manuscript; and the author has read and approved the final manuscript.

Conflict-of-interest statement: The author declares no conflicts of interest.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Predrag Jovanovic, PhD, Associate Professor, Chief Physician, Consultant, Head, Faculty of Medicine, Department of Internal Medicine, University of Tuzla, Univerzitetska 1, Tuzla 75000, Tuzla Canton, Bosnia and Herzegovina. predrag.jovanovic@untz.ba

Received: September 11, 2025
Revised: September 18, 2025
Accepted: November 4, 2025
Published online: December 21, 2025
Processing time: 99 Days and 3.5 Hours

Core Tip

Core Tip: Insertion time is not merely duration but a marker of procedural complexity. Clinicians should view prolonged insertion time as a potential risk factor for reduced adenoma detection, unless offset by adequate withdrawal. Predictive models that incorporate insertion-to-withdrawal ratios and established quality benchmarks may better guide colonoscopy performance and improve outcomes in colorectal cancer prevention.