High-definition colonoscopy increases adenoma detection rate

Jrebi, Nezar; Hefty, Matthew; Jalouta, Tarek; Ogilvie, James W.; Davis, Alan T.; Asgeirsson, Theodor; Luchtefeld, Martin

doi:10.1007/s00464-016-4986-7

Cited by 26 publications

(17 citation statements)

References 17 publications

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“…In terms of MAC, HD-WLE was related to higher MAC than SDC (MD, 0.098; 95% CI, 0.039-0.157). 6 Four more RCTs [13][14][15][16] as well as various observational and retrospective studies 5,[20][21][22] have since been published. Thus, we analyzed only RCTs to provide robust data in the field of evidencebased decision making.…”

Section: Discussionmentioning

confidence: 99%

High-definition colonoscopy for improving adenoma detection: a systematic review and meta-analysis of randomized controlled studies

Tziatzios

Gkolfakis

Lazaridis

et al. 2020

Gastrointestinal Endoscopy

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Background and Aims: Previous meta-analysis showed marginal benefit of high-definition white-light endoscopy (HD-WLE) over standard-definition colonoscopy (SDC) for adenoma detection, but with residual uncertainty due to inclusion of nonrandomized studies. We aimed to further assess the effect of HD-WLE on adenoma detection by including only randomized controlled trials (RCTs). Methods: A literature search was performed for RCTs evaluating HD-WLE versus SDC in terms of adenoma, advanced adenoma, and serrated sessile adenoma detection rates as well as the mean number of adenomas per colonoscopy (MAC), the mean number of advanced adenomas per colonoscopy (MAAC), and the mean number of sessile serrated adenomas per colonoscopy (MSSAC). The effect size on study outcomes is presented as the risk ratio (RR; 95% confidence interval [CI]) or mean difference (MD; 95% CI). We assessed the strength of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: Six RCTs involving 4594 individuals (HD-WLE, 2323; SDC, 2271) were included. Clinical indications were screening (1 study), positive result for fecal occult blood test, personal/family history of colorectal cancer (1 study), and mixed indications (4 studies). Withdrawal time was similar between the 2 arms (MD, À0.06; 95% CI, À0.25 to 0.12; P Z .50). The adenoma detection rate was significantly higher in the HD-WLE arm compared with the SDC arm (40% vs 35%; RR, 1.13; 95% CI, 1.05-1.22; P Z .001; I 2 Z 0%; GRADE, low). This effect was consistent for advanced and sessile serrated adenoma detection rates (

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Section: Discussionmentioning

confidence: 99%

High-definition colonoscopy for improving adenoma detection: a systematic review and meta-analysis of randomized controlled studies

Tziatzios

Gkolfakis

Lazaridis

et al. 2020

Gastrointestinal Endoscopy

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“…Nowadays, HD endoscopes are recommended because they are known to significantly improve ADR and should be considered for all screening colonoscopies in the LS population. 24 …”

Section: Discussionmentioning

confidence: 99%

Impact of an optimized colonoscopic screening program for patients with Lynch syndrome: 6-year results of a specialized French network

Perrod

Samaha

Rahmi

et al. 2018

Therap Adv Gastroenterol

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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. Colonoscopies were defined as optimal when all the screening criteria were respected. We compared colonoscopy quality and colonoscopy detection rate before and after PRED-IdF inclusion, including polyp detection rate (PDR), adenoma detection rate (ADR) and cancer detection rate (CDR).Results:Between January 2010 and January 2016, 144 LS patients were consecutively included (male/female = 50/94, mean age = 51 ± 13 years and mutations: MLH1 = 39%, MSH2 = 44%, MSH6 = 15%, PMS2 = 1%). A total of 564 colonoscopies were analyzed, 353 after inclusion and 211 before. After PRED-IdF inclusion, 98/144 (68%) patients had optimal screening colonoscopies versus 33/132 (25%) before (p < 0.0005). The optimal colonoscopy rate was 304/353 (86%) after inclusion versus 87/211 (41%) before, (p < 0.0001). PRED-IdF inclusion was associated with a reduction of CRC occurrence with a CDR of 1/353 (0.3%) after inclusion versus 6/211 (2.8%) before (p = 0.012). ADR and PDR were 99/353 (28%) versus 60/211 (28.8%) (p > 0.05) and 167/353 (48.1%) versus 90/211 (42.2%) (p > 0.05), respectively after and before inclusion.Conclusions:An optimized colonoscopic surveillance program in LS patients seems to improve colonoscopic screening quality and might possibly decrease colorectal interval cancer occurrence. Long-term cohort studies are needed to confirm these results.

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“…Such improvements are usually incorporated with a generation change of instruments and include widening of the angle of view, high-definition imaging (HDI), or enhanced imaging methods such as narrow-band imaging, Fujinon intelligent chromoendoscopy, blue-light imaging, or I-Scan. However, despite some encouraging reports, especially initially in the assessment, 9,10 none of those features have been consistently shown to improve ADR when finally tested in randomized studies, as summarized in meta-analyses on HDI 11 or image enhancement techniques. [12][13][14][15][16][17] Therefore, it might take several combined changes in endoscope technology before an increase in ADR can be measured.…”

Section: Introductionmentioning

confidence: 99%

Impact of 2 generational improvements in colonoscopes on adenoma miss rates: results of a prospective randomized multicenter tandem study

Pioche

Denis

Allescher

et al. 2018

Gastrointestinal Endoscopy

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High-definition colonoscopy increases adenoma detection rate

Cited by 26 publications

References 17 publications

High-definition colonoscopy for improving adenoma detection: a systematic review and meta-analysis of randomized controlled studies

High-definition colonoscopy for improving adenoma detection: a systematic review and meta-analysis of randomized controlled studies

Impact of an optimized colonoscopic screening program for patients with Lynch syndrome: 6-year results of a specialized French network

Impact of 2 generational improvements in colonoscopes on adenoma miss rates: results of a prospective randomized multicenter tandem study

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