Subsite-specific colorectal cancer risk in the colorectal endoscopy era

Expected long-term impact of the German screening colonoscopy programme on colorectal cancer prevention: Analyses based on 4,407,971 screening colonoscopies

“…The predicted overall and age specific patterns of reduction in the CRC burden are in agreement with epidemiological observations from the United States, where screening sigmoidoscopy and screening colonoscopy have been offered and increasingly used since the 1980s and the 1990s, respectively [14], and quite substantial decreases in incidence and resection rates of distal and proximal CRC were seen since the 1990s and the first decade of the 21st century, respectively [15][16][17]. Notably, the decrease in distal cancer incidence was most pronounced in the oldest age groups, whereas no decrease was seen for ages below 50 years for which screening is not generally recommended, and only a modest decrease was seen for age group 50-59 [15].…”

The water exchange method for colonoscopy-effect of coaching

“…Overseas investigators reported that traditional colonoscopy failed to reduce colorectal cancer mortality in the right colon as effectively as in the left colon. [38][39][40] The most recent assessments of epidemiologic data in the U.S. 41,42 have confirmed these shortcomings of traditional colonoscopy. The possible increase in ADR by water exchange especially in the proximal colon suggests that production pressure which has been linked to jeopardized colonoscopy quality 43 need not be the sole justification for overlooking methodological details of water exchange.…”

Benchmarking and quality-screening colonoscopy

“…Even US epidemiologic data have demonstrated a similar pattern. 5,6 Adenoma detection rate but not cecal intubation rate is an independent predictor of risk of interval colorectal cancer after screening colonoscopy. 7 Taken together focusing on maneuvers that enhance detection of proximal lesions with malignant potential is a prudent approach for benchmarking to improve the quality and outcome of screening colonoscopy.…”