Earlier diagnosis of cancer of the colon through colonic endoscopy (colonoscopy)

Abstract

Colonoscopy is a major advance in the diagnosis, treatment, and investigation of diseases of the colon and rectum, particularly cancer. Based on our early experience, this technique can be expected to bring malignant and premalignant lesions of the large intestine to clinical attention at an earlier stage and thus effect a higher cure rate. The large majority of colonic polyps can be removed from all levels of the colon safely by the endoscopic route, eliminating the need for laparotomy in most cases and reducing costs of care materially. Errors in radiologic diagnosis, positive, negative, or equivocal, can he materially reduced when there is endoscopic confirmation. Thus, colonoscopy and the contrast enema may be regarded as complementary studies. Colonoscopy is an extremely safe method of study when carried out in expert hands: it can be done on an ambulatory basis. There is an urgent need for good training programs to ensure adequate availability of the method to the public. The technique is also an excellent means of followup for patients who have been treated for cancer, polyps, or inflammatory diseases of the colon and rectum. Pertinent and illustrative case material gleaned from a clinical experience of over 4000 colonoscopies and 600 endoscopic polyp removals is presented.

Colorectal Cancer Screening: Impact of COVID-19 Pandemic and Possible Consequences

“…Currently used screening methods include invasive tests such as colonoscopy and flexible sigmoidoscopy; or minimally invasive tests like colon capsule endoscopy (CCE); and noninvasive tests-the guaiac-based fecal occult blood test (FOBT), fecal immunochemical test (FIT), FIT-DNA test, and computed tomography colonography (CTC) [15]. Colonoscopy is arguably the most effective (gold-standard) screening method currently available since the invention of fiber-optic endoscopes in the late 1960s [16,17]. It gives physicians the ability to examine the entire colon and rectum of a patient and remove polyps at the same time [17].…”

“…Colonoscopy is arguably the most effective (gold-standard) screening method currently available since the invention of fiber-optic endoscopes in the late 1960s [16,17]. It gives physicians the ability to examine the entire colon and rectum of a patient and remove polyps at the same time [17]. The first rigid sigmoidoscope was available in 1805 (before the start of 1918 pandemic) to examine the last part of the colon for screening purposes [18].…”

Noninvasive DNA methylation biomarkers in colorectal cancer: A systematic review

“…Early screening and diagnosis of CRC brings timely treatment and significantly decreased mortality in these patients. Serum carcinoembryonic antigen (CEA) level, fecal occult blood test (FOBT) and conventional colonoscopy have long been used for the screening and surveillance of CRC. The former two modalities, with a low medical cost, achieve a high compliance among the individuals; however, false positivity and negativity are inevitable .…”

Postpolypectomy Bleeding Prevention and More Complete Precancerous Colon Polyp Removal With Endoscopic Mucosal Stripping (EMS)

“…Aside from EMR and ESD, little attention has been given to polypectomy technique as a risk factor for postpolypectomy bleeding. Indeed, the generally accepted and widely used traditional snare polypectomy technique to guillotine the ensnared polyp with or without heat coagulation has not changed much for nearly 5 decades ( 32 – 37 ). To prevent postpolypectomy bleeding, one of the authors (ZJC) developed endoscopic mucosal stripping (EMS) as a modification of traditional cold snare polypectomy (TCSP) to avoid cutting into blood vessel-rich submucosa because all non-cancerous polyps which are the most frequent type of polyps seen during screening colonoscopy are by definition confined to mucosa and do not extend into submucosa.…”