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By moving average method, endoscopists reached a mean ADR of 20% at 216 and 261 procedures over blocks of 50 and 100 procedures, respectively. The total number of procedures, number of daily procedures, patient age and gender, bowel preparation, sedation, and diverticulosis were significantly associated with adenoma detection. This is the first study to investigate the learning curve of ADR for those well-trained endoscopists who have a CIR≥90% and start to perform colonoscopy independently. Two hundred procedures might be an optimal