Download PDF
CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(03): E463-E466
DOI: 10.1055/a-2280-7096
Editorial

Standard screening high-definition colonoscopy without any optimization device is no longer relevant: Time to move to optimized screening colonoscopy

David Karsenti 
1   Digestive Endoscopy Unit, Clinique Paris-Bercy, Charenton-le-Pont, France (Ringgold ID: RIN568079)
2   Centre d'Explorations Digestives, Paris, France
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Optimizing the adenoma detection rate (ADR) is a major goal in colorectal cancer (CCR) screening, as it has long been established that ADR is inversely proportional to the risk of post-colonoscopy CRC occurrence. To achieve this goal, many optimization devices have been developed, and numerous randomized controlled trials have been conducted to evaluate the benefits of these devices compared with a "standard arm," which corresponds to date to high-definition white light (HD-WLI) colonoscopy. Numerous studies have confirmed the positive impact of various optimization devices, such as caps, computer-aided detection, and contrast-enhanced technologies. Moreover, the different ways in which the devices can impact ADR make them complementary. However, despite substantial and consistent data, practices remain unchanged, and HD-WLI colonoscopy, considered the "standard," is still routinely performed without any optimization devices. The objective of this viewpoint is to understand the barriers to change and to show why standard screening colonoscopy without the use of any optimization devices should no longer be considered relevant in 2024.

Keywords

Polyps / adenomas / ... - CRC screening - Endoscopy Lower GI Tract - Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE...) - Quality and logistical aspects - Quality management


Publication History

Received: 03 January 2024

Accepted after revision: 16 February 2024

Article published online:
28 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Corley DA, Jensen CD, Marks AR. et al. Adenoma detection rate and risk of colorectal cancer and death. N Engl J Med 2014; 370: 1298-306
    CrossrefPubMedSearch in Google Scholar
  • 2 Ngu WS, Bevan R, Tsiamoulos ZP. et al. Improved adenoma detection with Endocuff Vision: the ADENOMA randomised controlled trial. Gut 2019; 68: 280-288
    CrossrefPubMedSearch in Google Scholar
  • 3 Karsenti D, Tharsis G, Perrot B. et al. Adenoma detection by Endocuff-assisted versus standard colonoscopy in routine practice: a cluster-randomised crossover trial. Gut 2020; 69: 2159-2164
    CrossrefPubMedSearch in Google Scholar
  • 4 Weissman S, Mehta TI, Stein DJ. et al. Comparative efficacy of endoscopic assist devices on colonic adenoma detection: A systematic review with network meta-analysis. J Clin Gastroenterol 2022; 56: 889-894
    CrossrefPubMedSearch in Google Scholar
  • 5 Thayalasekaran S, Bhattacharyya R, Chedgy F. et al. Randomized controlled trial of EndoRings assisted colonoscopy versus standard colonoscopy. Dig Endosc 2023; 35: 354-360
    CrossrefPubMedSearch in Google Scholar
  • 6 Karsenti D, Tharsis G, Perrot B. et al. Effect of real-time computer-aided detection of colorectal adenoma in routine colonoscopy (COLO-GENIUS): a single-centre randomised controlled trial. Lancet Gastroenterol Hepatol 2023; 8: 726-734
    CrossrefPubMedSearch in Google Scholar
  • 7 Patel HK, Chandrasekar VT, Srinivasan S. et al. Second-generation distal attachment cuff improves adenoma detection rate: meta-analysis of randomized controlled trials. Gastrointest Endosc 2021; 93: 544-553
    CrossrefPubMedSearch in Google Scholar
  • 8 Xu H, Tang RSY, Lam TYT. et al. Artificial intelligence-assisted colonoscopy for colorectal cancer screening: A multicenter randomized controlled trial. Clin Gastroenterol Hepatol 2023; 21: 337-346
    CrossrefPubMedSearch in Google Scholar
  • 9 Repici A, Spadaccini M, Antonelli G. et al. Artificial intelligence and colonoscopy experience: lessons from two randomised trials. Gut 2022; 71: 757-765
    CrossrefPubMedSearch in Google Scholar
  • 10 Hassan C, Spadaccini M, Iannone A. et al. Performance of artificial intelligence in colonoscopy for adenoma and polyp detection: a systematic review and meta-analysis. Gastrointest Endosc 2021; 93: 77-85
    CrossrefPubMedSearch in Google Scholar
  • 11 Wang J, Ye C, Wu K. et al. The effect of linked color imaging for adenoma detection: A meta-analysis of randomized controlled studies. J Gastrointest Liver Dis 2022; 31: 67-73
    CrossrefPubMedSearch in Google Scholar
  • 12 Li J, Zhang D, Wei Y. et al. Colorectal sessile serrated lesion detection using linked color imaging: A multicenter, parallel randomized controlled trial. Clin Gastroenterol Hepatol 2023; 21: 328-336
    CrossrefPubMedSearch in Google Scholar
  • 13 Karsenti D, Perrod G, Perrot B. et al. Impact of linked color imaging on the proximal adenoma miss rate: a multicenter tandem randomized controlled trial. The COCORICO trial. Endoscopy 2024 (In press).
    PubMed
  • 14 Aziz M, Ahmed Z, Haghbin H. et al. Does i-scan improve adenoma detection rate compared to high-definition colonoscopy? A systematic review and meta-analysis. Endosc Int Open 2022; 10: E824-E831
    Thieme ConnectPubMedSearch in Google Scholar
  • 15 Antonelli G, Bevivino G, Pecere S. et al. Texture and color enhancement imaging versus high definition white-light endoscopy for detection of colorectal neoplasia: a randomized trial. Endoscopy 2023; 55: 1072-1080
    Thieme ConnectPubMedSearch in Google Scholar
  • 16 Li L, Ou Y, Yue H. et al. Comparison of the detection of colorectal lesions in different endoscopic modalities: A network meta-analysis and systematic review. Exp Ther Med 2019; 18: 154-162
    CrossrefPubMedSearch in Google Scholar
  • 17 Li J, Chen K, Wei Y. et al. Colorectal sessile serrated lesion detection using linked-color imaging versus narrow-band imaging: a parallel randomized controlled trial. Endoscopy 2023; 55: 546-554
    Thieme ConnectPubMedSearch in Google Scholar
  • 18 Aziz M, Haghbin H, Sayeh W. et al. Comparison of artificial intelligence with other interventions to improve adenoma detection rate for colonoscopy: A network meta-analysis. J Clin Gastroenterol 2024; 58: 143-155
    CrossrefPubMedSearch in Google Scholar
  • 19 Neumann H, Kreft A, Sivanathan V. et al. Evaluation of novel LCI CAD EYE system for real time detection of colon polyps. PLoS One 2021; 16: e0255955
    CrossrefPubMedSearch in Google Scholar
  • 20 Aniwan S, Mekritthikrai K, Kerr SJ. et al. Computer-aided detection, mucosal exposure device, their combination, and standard colonoscopy for adenoma detection: a randomized controlled trial. Gastrointest Endosc 2023; 97: 507-516
    CrossrefPubMedSearch in Google Scholar
  • 21 Spadaccini M, Hassan C, Rondonotti E. et al. Combination of mucosa-exposure device and computer-aided detection for adenoma detection during colonoscopy: a randomized trial. Gastroenterology CERTAIN Study Group 2023; 165: 244-251
    CrossrefPubMedSearch in Google Scholar
  • 22 Ahmad A, Wilson A, Haycock A. et al. Evaluation of a real-time computer-aided polyp detection system during screening colonoscopy: AI-DETECT study. Endoscopy 2023; 55: 313-319
    Thieme ConnectPubMedSearch in Google Scholar
  • 23 Rembacken B, Hassan C, Riemann JF. et al. Quality in screening colonoscopy: position statement of the European Society of Gastrointestinal Endoscopy (ESGE). Endoscopy 2012; 44: 957-68
    Thieme ConnectPubMedSearch in Google Scholar
  • 24 Kaminski MF, Thomas-Gibson S, Bugajski M. et al. Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy 2017; 49: 378-397
    CrossrefPubMedSearch in Google Scholar
  • 25 Zimmermann-Fraedrich K, Groth S, Sehner S. et al. Effects of two instrument-generation changes on adenoma detection rate during screening colonoscopy: results from a prospective randomized comparative study. Endoscopy 2018; 50: 878-885
    Thieme ConnectPubMedSearch in Google Scholar
  • 26 Pioche M, Denis A, Allescher HD. et al. Impact of 2 generational improvements in colonoscopes on adenoma miss rates: results of a prospective randomized multicenter tandem study. Gastrointest Endosc 2018; 88: 107-116
    CrossrefPubMedSearch in Google Scholar
  • 27 Schottinger JE, Jensen CD, Ghai NR. et al. Association of physician adenoma detection rates with postcolonoscopy Colorectal Cancer. JAMA 2022; 327: 2114-2122
    CrossrefPubMedSearch in Google Scholar
  • 28 Ladabaum U, Dominitz JA, Kahi C. et al. Strategies for colorectal cancer screening. Gastroenterology 2020; 158: 418-432
    CrossrefPubMedSearch in Google Scholar
  • 29 Shaukat A, Kahi CJ, Burke CA. et al. ACG Clinical Guidelines: Colorectal Cancer Screening 2021. Am J Gastroenterol 2021; 116: 458-479
    CrossrefPubMedSearch in Google Scholar
  • 30 Hassan C, Antonelli G, Dumonceau JM. et al. Post-polypectomy colonoscopy surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2020. Endoscopy 2020; 52: 687-700
    Thieme ConnectPubMedSearch in Google Scholar