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4 % to 29.2 % ( = 0.035), and reduction in moderate/severe pain experienced by women, from 38.2 % to 33.6 % ( = 0.043); no significant changes were found in nonparticipating centers. Over 5 years, 20 participating and 18 nonparticipating centers contributed 85 691 and 41 569 colonoscopies, respectively. In participating centers, polyp detection rate increased linearly ( = 0.003), and pain decreased linearly in women ( = 0.004). Nonparticipating centers did not show any significant time trend during the study period. Participation i
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