New-Generation High-Definition Colonoscopes Increase Adenoma Detection when Screening a Moderate-Risk Population for Colorectal Cancer

Bond, Ashley, O'Toole, Paul, Fisher, Gareth, Subramanian, Sreedhar, Haslam, Neil, Probert, Chris ORCID: 0000-0003-0477-6714, Cox, Trevor and Sarkar, Sanchoy (2017) New-Generation High-Definition Colonoscopes Increase Adenoma Detection when Screening a Moderate-Risk Population for Colorectal Cancer CLINICAL COLORECTAL CANCER, 16 (1). pp. 44-50. ISSN 1533-0028, 1938-0674

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Abstract

This retrospect observational study of 395 patients undergoing colonoscopy as part of the UK Bowel Cancer Screening Programme, demonstrated that the Olympus H290 LUCERA ELITE high-definition colonoscopes improved adenoma detection within the moderate-risk population. Moreover, it did so when used by operators with a higher-than-average baseline adenoma detection rate. Background and Aim Adenoma detection rate (ADR) is the most important quality indicator for screening colonoscopy, due to its association with colorectal cancer outcomes. As a result, a number of techniques and technologies have been proposed that have the potential to improve ADR. The aim of this study was to assess the potential impact of new-generation high-definition (HD) colonoscopy on ADR within the Bowel Cancer Screening Programme (BCSP). Method This was a retrospective single-center observational study in patients undergoing an index screening colonoscopy. The examination was performed with either standard-definition colonoscopes (Olympus Q240/Q260 series) or HD colonoscopes (Olympus HQ290 EVIS LUCERA ELITE system) with the primary outcome measures of ADR and mean adenoma per procedure (MAP) between the 2 groups. Results A total of 395 patients (60.5% male, mean age 66.8 years) underwent screening colonoscopy with 45% performed with HD colonoscopes. The cecal intubation rate was 97.5% on an intention-to-treat basis and ADR was 68.6%. ADR with standard-definition was 63.13%, compared with 75.71% with HD (P = .007). The MAP in the HD group was 2.1 (± 2.0), whereas in the standard-definition group it was 1.6 (± 1.8) (P = .01). There was no significant difference in withdrawal time between the 2 groups. In the multivariate regression model, only HD scopes (P = .03) and male sex (P = .04) independently influenced ADR. Conclusion Olympus H290 LUCERA ELITE HD colonoscopes improved adenoma detection within the moderate-risk population. A 12% improvement in ADR might be expected to increase significantly the protection afforded by colonoscopy against subsequent colorectal cancer mortality.

Item Type:	Article
Uncontrolled Keywords:	Adenoma detection rate, Bowel cancer screening program, Colonoscopy, Colorectal cancer, High definition
Depositing User:	Symplectic Admin
Date Deposited:	30 Aug 2016 10:09
Last Modified:	23 May 2026 00:19
DOI:	10.1016/j.clcc.2016.07.006
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3003067
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