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Background and study aims  Adenomas per colonoscopy (APC) and adenomas per positive patient (APP) have been proposed as additional quality indicators but their association with adenoma detection rate (ADR) is not well studied. The aim of our study was to evaluate the variability in APC and APP, their association with ADR, and associated risk factors in screening colonoscopies from a community practice. Patients and methods  We calculated the APC, APP, and ADR from all screening colonoscopies performed over 5 years. We used adjusted hiera