Full-spectrum (FUSE) versus standard forward-viewing colonoscopy in an organised colorectal cancer screening programme

Hassan, Cesare; Senore, Carlo; Radaelli, Franco; Pretis, G. De; Sassatelli, Romano; Arrigoni, Arrigo; Manes, Gianpiero; Amato, Arnaldo; Anderloni, Andrea; Armelao, Franco; Mondardini, A.; Spada, Cristiano; Omazzi, Barbara; Cavina, Maurizio; Miori, G.; Campanale, Chiara; Sereni, Giuliana; Segnan, Nereo; Repici, Alessandro

doi:10.1136/gutjnl-2016-311906

Cited by 55 publications

(57 citation statements)

References 30 publications

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“…Miss rate of polyps has been shown to be substantially lower with full-spectrum endoscopy (FUSE) compared with standard forward-viewing (SFV) colonoscopy in a tandem study at per polyp analysis. However, there is uncertainty on whether FUSE is also associated with a higher detection rate of colorectal neoplasia, especially advanced lesions, in per patient analysis [24]. However, about 88.8% thought that early endoscopy contributes to the reduction of the complications of colorectal cancer.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Awareness Levels toward Colorectal Cancer Early Detection and Prevention in Saudi Arabia

Ahmed¹

2017

GHOA

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Section: Discussionmentioning

confidence: 99%

Assessment of Awareness Levels toward Colorectal Cancer Early Detection and Prevention in Saudi Arabia

Ahmed¹

2017

GHOA

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“…All resected lesions, either by forceps or snare, were sent to pathology in separate jars and were processed and stained for histopathology using standard methods and evaluated by expert pathologists (one in each center) according to the Vienna criteria. 7,14 An advanced adenoma was defined as an adenoma >10 mm and/or with villous component > 20%, and/or high-grade dysplasia.…”

Section: Histopathologymentioning

confidence: 99%

“…4 The crossover design mitigates all such limitations, but it represents a fully artificial design, and it is also at high risk of operator bias, as the unblinded endoscopist performing the first procedure is aware of the subsequent colonoscopy to be performed. 4 When validating the same innovations with different study methodologies, inconsistent results have been frequently reported, [5][6][7][8][9] generating uncertainty as to how well the 2 study designs actually correspond.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic yield and miss rate of EndoRings in an organized colorectal cancer screening program: the SMART (Study Methodology for ADR-Related Technology) trial

Hassan

Senore

Manes³

et al. 2019

Gastrointestinal Endoscopy

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Background and aims. The add-on EndoRings has been claimed to improve adenoma detection at colonoscopy, but available data are inconsistent. When testing a new technology, parallel and crossover methodologies measure different outcomes, leaving uncertainty on their correspondence. Aims of this study were to compare the diagnostic yield and miss rate of the EndoRings for colorectal neoplasia.Methods. Consecutive subjects undergoing colonoscopy after a positive fecal immunochemical test (FIT) within organized screening program in 7 Italian centers, were randomized between a parallel (EndoRings or Standard) or a crossover (EndoRings/Standard or Standard/EndoRings) methodology. Outcomes measures were the detection rates of (advanced) adenomas (A-)ADR in the parallel arms and miss rate of adenomas in the crossover arms. Results:Of 958 eligible subjects, 927 (317 EndoRings; 317 Standard; 142 EndoRings/Standard; 151 Standard/Endorings) were included in the final analysis. In the parallel arms (mean ADR: 51.3%; mean AADR: 25.4%), no difference between Standard and EndoRings was found for both ADR (RR, 1.10; 95% CI, 0.95-1.28) and A-ADR (RR, 1.16; 95% CI, 0.88-1.51), as well as for the mean number of adenomas and advanced adenomas per patient (EndoRings: 1.9±1.3 and 1.0±1.2; Standard 2.1±1.5 and 1.0±1.2; p=NS for both comparisons). In the crossover arms, no difference in miss rate for adenomas between EndoRings and Standard was found at per-polyp (RR, 1.43; 95% CI, 0.97-2.10), as well as at per-patient analysis (24% vs 26%; p=0.76). Conclusions:No statistically significant difference in diagnostic yield and miss rate between EndoRings and Standard colonoscopy was detected in FIT+ patients. A clinically relevant correspondence between miss and detection rates was shown, supporting a cause-effect relationship.

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“…No significant difference in ADR between FUSE (43.6%) and standard forward view (45.5%). 43 Several other devices are available (mostly outside the US) to improve the field of view, and these generally result in an improvement in ADR by about 7%, but the cost of these devices precludes routine use. 34…”

Section: Fuse Regional Screening Program Of Fit-positive Patientsmentioning

confidence: 99%

Does Increased Adenoma Detection Reduce the Risk of Colorectal Cancer, and How Good Do We Need to Be?

Dilly

Kahi

2019

Curr Gastroenterol Rep

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Purpose of review:Colorectal cancer is largely preventable with colonoscopy and other screening modalities. However, the effectiveness of screening and surveillance depends on the quality of the colonoscopy exam. Adenoma detection rate is the best-validated metric by which we measure individual physicians' performance. Recent findings:As we gather more data on the ADR, we are learning that older benchmarks may be inappropriately low. We have evidence that improving ADR leads to reductions in PCCRC. Two studies have demonstrated that when a colonoscopy is performed by physicians with higher ADRs, patients are less likely to have advanced adenomas on the first surveillance exam. Finally, there is at least some evidence that higher ADRs do not lead to more cumulative surveillance exams. Summary:The ADR is a useful outcome measure that can provide individual endoscopists and their patients with information about the likelihood of their patients developing PCCRC. To achieve the lowest possible PCCRC rate, we should be striving for higher ADRs. While strategies and innovations may help a bit in improving ADRs, our efforts should focus on ensuring a complete mucosal exam for each patient. Behavioral psychology theories may provide useful frameworks for studying motivating factors that drive a careful exam.

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Full-spectrum (FUSE) versus standard forward-viewing colonoscopy in an organised colorectal cancer screening programme

Abstract: ISRCTN10357435.

Cited by 55 publications

References 30 publications

Assessment of Awareness Levels toward Colorectal Cancer Early Detection and Prevention in Saudi Arabia

Assessment of Awareness Levels toward Colorectal Cancer Early Detection and Prevention in Saudi Arabia

Diagnostic yield and miss rate of EndoRings in an organized colorectal cancer screening program: the SMART (Study Methodology for ADR-Related Technology) trial

Does Increased Adenoma Detection Reduce the Risk of Colorectal Cancer, and How Good Do We Need to Be?

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