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Adenoma detection rate

Trilokesh D Kidambi, Jonathan P Terdiman, Najwa El-Nachef, Aparajita Singh, Michael G Kattah, Jeffrey K Lee
BACKGROUND & AIMS: I-scan is an electronic chromoendoscopy technology that improves resolution of epithelial and mucosal surfaces and vessels. We performed a randomized controlled trial to compare detection of adenomas by i-scan vs standard high-definition white-light (HDWL) colonoscopy. METHODS: From February 1 through December 31, 2017, 740 outpatients (50-75 years old) undergoing screening and surveillance for colorectal neoplasia were randomly assigned to groups that received colonoscopies with i-scan 1 (surface and contrast enhancement) or HDWL...
June 20, 2018: Clinical Gastroenterology and Hepatology
Paul F Pinsky, Magnus Loberg, Carlo Senore, Kate Wooldrage, Wendy Atkin, Michael Bretthauer, Amanda J Cross, Geir Hoff, Oyvind Holme, Mette Kalager, Nereo Segnan, Robert E Schoen
BACKGROUND & AIMS: Screening for colorectal cancer (CRC) with sigmoidoscopy reduces CRC incidence by detecting and removing adenomas. The number needed to screen is a measure of screening efficiency, but is not directly associated with adenoma removal. We propose 2 new metrics for quantifying the relationship between adenoma removal and CRC prevented: number of adenomas needed to remove (NNR) and adenoma dwell time avoided (DTA). METHODS: We collected data from 4 randomized trials of sigmoidoscopy screening (in the United States and 3 in Europe) to assess NNR and DTA...
June 20, 2018: Gastroenterology
Gregor Urban, Priyam Tripathi, Talal Alkayali, Mohit Mittal, Farid Jalali, William Karnes, Pierre Baldi
BACKGROUND & AIMS: The benefit of colonoscopy for colorectal cancer prevention depends on the adenoma detection rate (ADR). The ADR should reflect adenoma prevalence rate, estimated to be greater than 50% among the screening-age population. Yet the rate of adenoma detection by colonoscopists varies from 7% to 53%. It is estimated that every 1% increase in ADR reduces the risk of interval colorectal cancers by 3-6%. New strategies are needed to increase the ADR during colonoscopy. We tested the ability of computer-assisted image analysis, with convolutional neural networks (a deep learning model for image analysis), to improve polyp detection, a surrogate of ADR...
June 18, 2018: Gastroenterology
Yunshuai Wang, Zhaohui Li, Wenxian Li, Shuaifeng Liu, Baowei Han
The aim of the present study was to examine the diagnosis of methylation of CDX2 gene promoter in colorectal cancer (CRC) and assessed its value in the prediction of treatment efficacy. Sixty patients who were diagnosed as CRCs for the first time, 60 patients with hyperplastic polyps (HPs) and adenomas, and 60 patients with inflammatory lesions or healthy patients (control group) were included in the present study. The methylation levels of CDX2 gene promoter were detected by methylation-specific polymerase chain reaction (MSP), and the expression levels of CDX2 mRNA were detected by fluorescence quantitative PCR...
July 2018: Oncology Letters
Anu E Obaro, David N Burling, Andrew A Plumb
Colorectal cancer (CRC) incidence and mortality can be significantly reduced by population screening. Several different screening methods are currently in use, and this review focuses specifically on the imaging technique computed tomography colonography (CTC). The challenges and logistics of CTC screening, as well as the importance of test accuracy, uptake, quality assurance and cost-effectiveness will be discussed. With comparable advanced adenoma detection rates to colonoscopy (the most commonly used whole-colon investigation), CTC is a less invasive alternative, requiring less laxative, and with the potential benefit that it permits assessment of extra colonic structures...
June 21, 2018: British Journal of Radiology
Peel Jung, Su B Park, Hyung W Kim, Dae H Kang, Cheol W Choi, Su J Kim, Hyeong S Nam, Dae G Ryu, Joung B Hong, Dong J Kim
BACKGROUND: Endoscopic inspection of colonic mucosa is disturbed by colonic folds and peristalsis, which may result in missed polyps. Cimetropium bromide, an antispasmodic agent, inhibits peristalsis and colonic spasms, which may improve polyp detection. The purpose of this randomized, double-blind, placebo-controlled study was to investigate whether cimetropium bromide could improve polyp and adenoma detection in the colorectum and right colon. METHODS: Patients undergoing screening or diagnostic colonoscopy were randomized to receive intravenous cimetropium bromide (5 mg) or placebo after cecal intubation...
June 2018: Medicine (Baltimore)
Hui Jia, Malcolm Koo, Yu-Hsi Hsieh, Chih-Wei Tseng, Chi-Tan Hu, Linhui Zhang, Tao Dong, Yanglin Pan, Felix W Leung
GOALS: To assess the factors associated with adenoma detection in propofol-sedated patients. BACKGROUNDS: Low adenoma detection rate (ADR) are linked to increased risk of interval cancer and related deaths. Compared with air insufflation (AI) colonoscopy, the method of water exchange (WE) significantly decreased insertion pain and increased ADR in unsedated patients. Deep sedation with propofol has been increasingly used in colonoscopy. One report suggested that WE significantly increased ADR in propofol-sedated patients, but the factors associated with adenoma detection were not analyzed...
June 15, 2018: Journal of Clinical Gastroenterology
Anna Duloy, Rena H Yadlapati, Mark Benson, Andrew J Gawron, Charles J Kahi, Tonya R Kaltenbach, Jessica McClure, Dyanna L Gregory, Rajesh N Keswani
BACKGROUND & AIMS: Adenoma detection rate (ADR) and serrated polyp detection rate (SDR) vary significantly among colonoscopists. Colonoscopy inspection quality (CIQ) is the quality with which a colonoscopist inspects for polyps and may explain some of this variation. We aimed to determine the relationship between CIQ and historical ADRs and SDRs in a cohort of colonoscopists and assess whether there is variation in CIQ components (fold examination, cleaning, and luminal distension) among colonoscopists with similar ADRs and SDRs...
June 13, 2018: Clinical Gastroenterology and Hepatology
Toyoki Kudo, Yutaka Saito, Hiroaki Ikematsu, Kinichi Hotta, Yoji Takeuchi, Masaaki Shimatani, Ken Kawakami, Naoto Tamai, Yuichi Mori, Yasuharu Maeda, Masayoshi Yamada, Taku Sakamoto, Takahisa Matsuda, Kenichiro Imai, Sayo Ito, Kenta Hamada, Norimasa Fukata, Takuya Inoue, Hisao Tajiri, Kenichi Yoshimura, Hideki Ishikawa, Shin-Ei Kudo
OBJECTIVES: Although colonoscopy is the criterion standard for detection of colorectal adenomas, some adenomas are missed. Full-spectrum endoscopy (FUSE) allows for observation with a 330° angle of view, which is expected to decrease the miss rate. However, no consensus has been reached regarding the superiority of FUSE over standard forward-viewing colonoscopy (SFVC) for detection of adenomas; we therefore compared new-generation FUSE and SFVC regarding colorectal adenoma miss rate (AMR) in this, the first reported randomized control trial using new-generation FUSE...
June 13, 2018: Gastrointestinal Endoscopy
Thomas Rösch, Lutz Altenhofen, Jens Kretschmann, Bernd Hagen, Hermann Brenner, Christian Pox, Wolff Schmiegel, Arno Theilmeier, Jens Aschenbeck, Andrea Tannapfel, Dominik von Stillfried, Katharina Zimmermann-Fraedrich, Karl Wegscheider
BACKGROUND & AIMS: A higher incidence of proximal interval cancers after colonoscopy has been reported in several follow-up studies. One possible explanation for this might be that proximally located adenomas have greater malignant potential. The aim of the present study was to assess the risk of malignancy in proximal versus distal adenomas in patients included in a large screening colonoscopy database; adenoma shape and the patients' age and sex distribution were also analyzed. METHODS: Data for 2007-2012 from the German National Screening Colonoscopy Registry, including 594,614 adenomas identified during 2,532,298 screening colonoscopies, were analyzed retrospectively...
June 11, 2018: Clinical Gastroenterology and Hepatology
Carolina Mangas-Sanjuan, Pedro Zapater, Joaquín Cubiella, Óscar Murcia, Luis Bujanda, Vicent Hernández, David Martínez-Ares, María Pellisé, Agustín Seoane, Ángel Lanas, David Nicolás-Pérez, Alberto Herreros-de-Tejada, María Chaparro, Guillermo Cacho, Servando Fernández-Díez, José-Carlos Marín-Gabriel, Enrique Quintero, Antoni Castells, Rodrigo Jover
Background: Guidelines recommend surveillance colonoscopies based exclusively on findings at baseline colonoscopy. This recommendation leads to the paradox that the higher the baseline colonoscopy quality, the more surveillance colonoscopies will be indicated according to current guidelines. Objective: The aim of this study was to evaluate the effect on follow-up findings of different quality metrics of the endoscopist performing the baseline colonoscopy. Methods: This retrospective cohort study included individuals with advanced adenomas at baseline colonoscopy...
May 2018: United European Gastroenterology Journal
María Lourdes Ruiz-Rebollo, Noelia Alcaide-Suárez, Beatriz Burgueño-Gómez, Beatriz Antolin-Melero, M ª Fe Muñoz-Moreno, Carmen Alonso-Martín, Javier Santos-Fernández
No abstract text is available yet for this article.
June 4, 2018: Gastroenterología y Hepatología
Zhihao Chen, Zhengqi Li, Xinying Yu, Guiqi Wang
Background/Aims: Recently, water exchange (WE) instead of water immersion (WI) for colonoscopy has been proposed to decrease pain and improve adenoma detection rate (ADR). This systematic review and meta-analysis is conducted to assess whether WE is superior to WI based on the published randomized controlled trials (RCTs). Materials and Methods: We searched studies from PubMed, Cochrane Central Register of Controlled Trials, EMBASE, and MEDLINE. Only RCTs were eligible for our study...
June 5, 2018: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Guillaume Perrod, Elia Samaha, Gabriel Rahmi, Sherine Khater, Leila Abbes, Camille Savale, Geraldine Perkins, Aziz Zaanan, Gilles Chatellier, Georgia Malamut, Christophe Cellier
Background: Despite colonoscopic screening, colorectal cancer (CRC) remains frequent in patients with Lynch syndrome (LS). The objective of this study was to evaluate the impact of an optimized colorectal screening program within a French dedicated network. Methods: All LS patients followed at our institution were consecutively included in the Prédisposition au Cancer Colorectal-Ile de France (PRED-IdF) network. Patients were offered an optimized screening program allowing an adjustment of the interval between colonoscopies, depending on bowel preparation, chromoendoscopy achievement and adenoma detection...
2018: Therapeutic Advances in Gastroenterology
A F D Di Stefano, M M Radicioni, A Vaccani, A Fransioli, L Longo, L Moro, A Repici
Methylene blue-MMX® tablets are proposed as an aid for detection and visualisation of adenomas and carcinomas in patients undergoing colonoscopy, by improving their detection rate and highlighting the presence of the intestinal dysplastic lesions. Single total doses of 100 and 200 mg were administered to healthy volunteers undergoing a bowel cleansing preparation and a full colonoscopy to investigate the colonic staining. The pharmacokinetics of methylene blue and the safety after exposure to the tablets were also investigated...
June 1, 2018: Contemporary Clinical Trials
A J Quyn, C G Fraser, G Stanners, F A Carey, C J Rees, B Moores, R J Steele
BACKGROUND: The delivery of the Scottish Bowel Screening Programme (SBoSP) is rooted in the provision of a high quality, effective and participant-centred service. Safe and effective colonoscopy forms an integral part of the process. Additional accreditation as part of a multi-faceted programme for participating colonoscopists, as in England, does not exist in Scotland. This study aimed to describe the quality of colonoscopy in the SBoSP and compare this to the English national screening standards...
June 4, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Georg Bier, Johann-Martin Hempel, Florian Grimm, Ulrike Ernemann, Benjamin Bender, Juergen Honegger
PURPOSE: To assess and quantify the prevalence and co-occurence of a sellar floor lowering and empty sella phenomenon in patients with GH (growth hormone)-secreting pituitary adenoma. METHODS: A total number of 159 acromegalic patients were included in this study, as well as two control groups (150 patients with non-GH-secreting adenomas and 50 patients without pituitary adenomas). Magnetic resonance images of all patients were evaluated for presence of an empty sella, downward and lateral tumor extension, and maximum superoinferior diameter of the mass...
July 2018: European Journal of Radiology
Paul James, Mehdi Hegagi, Mae Hegagi, Lilia Antonova, Alaa Rostom, Catherine Dube, Sanjay Murthy, Rakesh Goel, Avijit Chatterjee
BACKGROUND: Adenoma Detection Rate (ADR) is a validated colonoscopy quality indicator. In addition to overall ADR, Distal and Proximal Adenoma Detection Rates may provide important colonoscopy quality information. The goal of this study is to determine the association between distal and proximal adenoma detection (AD) and to identify factors contributing to overall, distal, and proximal AD. METHODS: This is a retrospective cohort study of patients with a noted family history of CRC or positive fecal occult blood test who underwent a screening colonoscopy at a regional colorectal cancer (CRC) screening center between May 2009 and December 2011...
May 30, 2018: BMC Gastroenterology
Furkan U Ertem, Uri Ladabaum, Ateev Mehrotra, Shahrzad Tehranian, Zhuo Shi, Melissa Saul, Michele Morris, Seth D Crockett, Robert E Schoen
BACKGROUND AND AIMS: Endoscopists who encounter an interval colorectal cancer (I-CRC) may be concerned about the implications because I-CRCs may represent a lapse in colonoscopy quality and a missed opportunity for prevention. To determine the I-CRC rate per colonoscopy examination and to examine the effect of colonoscopy volume and adenoma detection rate (ADR) on the number of I-CRCs attributable to an endoscopist. METHODS: We determined the rate of I-CRC diagnosis per outpatient colonoscopy examination by measuring the incidence of CRC diagnosis in practice and by assessing, via literature review, the percentage of cancers that are interval...
May 24, 2018: Gastrointestinal Endoscopy
Zhu Liu, Yue-Yue Li, Xue-Ting Luo, Chuan-Guo Guo, Ming-Ming Zhang, Zhen Li, Li-Xiang Li, Yan Zhang, Yan-Qing Li
AIM: In some Asian countries, guidelines recommend 2-L polyethylene glycol (PEG) without any additions as the standard bowel preparation (BP) regimen before colonoscopy, which is not sufficient for patients with previous colorectal surgery. The objective of this study was to investigate the efficacy of the split-dose 4-L PEG regimen on the quality of BP in Asian patients with previous colorectal surgery. METHODS: This was a single-center, prospective, randomized-controlled, endoscopist-blinded study...
May 22, 2018: Journal of Digestive Diseases
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