Colorectal Cancer Screening by Colonoscopy – Current Issues

Reguła, Jarosław

doi:10.1159/000108390

Cited by 12 publications

(6 citation statements)

References 82 publications

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“…Optical colonoscopy (OC) is regarded as the gold standard for colorectal tumor screening [1,2]. In recent years, it has been reported that OC is responsible for decreases in the incidence rate and mortality rate of colorectal carcinoma [3].…”

Section: Introductionmentioning

confidence: 99%

Evaluation for the Clinical Efficacy of Colon Capsule Endoscopy in the Detection of Laterally Spreading Tumors

Igawa

Oka²,

Tanaka³

et al. 2017

Digestion

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Background and Aim: The manner in which colorectal lesions are being detected with PillCam COLON2 capsule endoscopy (CCE2) has markedly improved in recent days. However, limited data are available on CCE2 for detecting laterally spreading tumors (LSTs). The aim of this study was to compare CCE2 with optical colonoscopy (OC), which is currently the gold standard used in the detection of LSTs. Methods: We performed a prospective, single-academic center study comparing CCE2 with OC in patients with LSTs diagnosed using OC, which was performed during the 3-month period prior to CCE2. We focused on the sensitivity and specificity of CCE2 for detecting LSTs. LSTs were classified into the LST-granular type (LST-G) or the LST-non-granular type (LST-NG). Results: Thirty patients (mean age 59.5 years) were enrolled. Of them, 21 LSTs (7 LST-Gs and 14 LST-NGs) were evaluated in this study. The mean diameter of the LSTs was 27 ± 15 mm (range 10-60 mm). Histopathological diagnoses of the LSTs were as follows: tubular adenoma, 12 cases (57%); sessile serrated adenoma/polyp (SSA/P), 4 cases (19%); Tis carcinoma, 1 case (5%); and T1 carcinoma, 4 cases (19 LSTs were found in the following locations: cecum, 1 case (5%); ascending colon, 6 cases (29%); transverse colon, 6 cases, (29%); descending colon, 1 case (5%); sigmoid colon, 3 cases (13%); and rectum, 4 cases (19%). The colon cleansing level was adequate in all cases. The sensitivity and specificity of CCE2 for detecting LSTs were 81 and 100% respectively. For detecting LST-Gs and LST-NGs, the sensitivity and specificity were 71 and 100%, and 86 and 100%, respectively. There were 4 false-negative cases (LST-G (18 mm), cecum; LST-G (20 mm), sigmoid colon; LST-NG (25 mm), transverse colon; LST-NG (20 mm), transverse colon). Conclusions: The sensitivity for detecting LSTs is lower with CCE2 than it is with OC, especially for LSTs located on the right colon or for SSA/P.

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Section: Introductionmentioning

confidence: 99%

Evaluation for the Clinical Efficacy of Colon Capsule Endoscopy in the Detection of Laterally Spreading Tumors

Igawa

Oka²,

Tanaka³

et al. 2017

Digestion

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“…The accuracy with which colorectal polyps or lesions can be detected is largely associated with the cleanliness of the luminal environment 24 25. Poor cleansing is also associated with an increased risk of peritoneal contamination should perforation occur 1 2.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of the Bowel Cleansing Impact Review (BOCLIR)

Doward

Wilburn

McKenna

et al. 2013

Frontline Gastroenterol

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ObjectiveAcceptability and tolerability of bowel cleansers influence whether patients are able to complete the prescribed dose and, consequently, the quality of the cleansing achieved. No standardised means of assessing patients’ experience of using bowel cleansing is currently available. The aim of the study was to develop the Bowel Cleansing Impact Review (BOCLIR) to assess patient response to bowel cleansing products.DesignContent was derived from qualitative interviews. Face and content validity were assessed via cognitive-debriefing interviews. Finally, patients completed the BOCLIR and a demographic questionnaire. Item response theory (Rasch analysis) was employed for item reduction and assessment of unidimensionality. Internal consistency and construct validity were also assessed.ResultsAnalysis of 40 interviews resulted in the production of three scales; patient satisfaction, symptomatic impact and activity limitations. Scales were designed to be used alone or together. 19 debriefing interviews demonstrated BOCLIR acceptability, relevance and ease of completion. The validation survey involved 166 patients (52% male, mean (SD) age 54.3 (15.2) years). After misfitting and redundant items were removed all scales fit the Rasch model confirming their unidimensionality. Cronbach's α-coefficients were high (0.77–0.94) indicating good internal consistency. Scores on the BOCLIR were related to patients’ willingness to use the product in future and ease of drinking the full preparation (p<0.01 for each scale).ConclusionsThe BOCLIR is a new measure consisting of three unidimensional scales (satisfaction, symptoms and activity limitations) with good psychometric and scaling properties. The BOCLIR will allow accurate assessment of patients’ response to bowel cleansing preparations.

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“…Compared to the fecal occult blood test, the cost of colonoscopy is significantly higher; however, it is sufficient to have it done every several years. In order to reach the true value of colonoscopy, cecal intubation is fundamental because it allows for inspection of the entire colon [1, 3, 15]. Together with the adenoma detection rate, the percentage of cecal intubation is considered to be the fundamental criterion for the evaluation of the quality of colonoscopy.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of magnetic scope navigation in screening endoscopic examination of colorectal cancer

et al. 2011

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BackgroundColorectal cancer is the most common cancer in Europe. Early diagnosis and treatment gives the patient a chance for complete recovery. Screening colonoscopies in the symptom-free patients are currently performed on a wide scale. The examinations are performed under local anesthesia which does not eliminate all discomfort and pain related to the examination. The aim of this study was to evaluate magnetic scope navigation in screening endoscopic examinations performed to detect early-stage colorectal cancer.MethodsThe study group consisted of 200 patients, aged 40–65 years, who were free from colon cancer symptoms. All patients underwent complete colonoscopy under local anesthesia. The equipment could be fitted with the scope that allows three-dimensional observation of instrument localization in the bowel. The examination was performed by three experienced endoscopists, each of whom performed over 5,000 colonoscopies. The patients were randomized to two groups: those whose equipment did not have 3D navigation (group I) and those whose equipment did have 3D navigation (group II). Each group consisted of 100 cases matched by gender, age, and BMI. The authors compared the duration of introducing instrument to cecum, the pulse rate before the examination and at the time the instrument reached the cecum, and subjective pain evaluation by the patient on the visual analog scale.ResultsGroup I consisted of 54 women and 46 men with a mean age of 54.6 years and mean BMI of 27.8 kg/m2, and group II had 58 women and 42 men, mean age of 55.1 years and mean BMI of 26.4 kg/m2. The average time it took for the instrument to reach the cecum was 216s in group I and 181s in group II (P < 0.05). Pain measured on the 10-point VAS scale was 2.44 in group I and 1.85 in group II (P < 0.05). The results showed a significantly shorter time for the instrument to reach the cecum in group II and significantly lower pain intensity during the examination was reported by the group II patients. No significant differences were found in the pulse measurements between the groups (P = 0.5).Conclusions3D navigation during colonoscopy decreases the time for the instrument to reach the cecum and lowers pain intensity subjectively reported by the patients. The use of 3D and the possibility to observe instrument localization and maneuvers brings more comfort to the patients.

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Colorectal Cancer Screening by Colonoscopy – Current Issues

Cited by 12 publications

References 82 publications

Evaluation for the Clinical Efficacy of Colon Capsule Endoscopy in the Detection of Laterally Spreading Tumors

Evaluation for the Clinical Efficacy of Colon Capsule Endoscopy in the Detection of Laterally Spreading Tumors

Development and validation of the Bowel Cleansing Impact Review (BOCLIR)

Evaluation of magnetic scope navigation in screening endoscopic examination of colorectal cancer

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