Endoscopy again supports Colorectal Cancer Awareness Month

Colorectal cancer (CRC) is an increasing burden, contributing 8.5 % of all cancer deaths, with more than 600 000 individuals dying every year worldwide. Identification and removal of precancerous and early invasive lesions has been recognized as the best strategy for combating this disease. Unsurprisingly, colonoscopy is thought to have a central role in the early detection and diagnosis of CRC. It is an important component of all general population screening programs and in surveillance for patients at high risk of developing CRC. Moreover, it also provides the possibility of minimally invasive therapy with consequent added value for patients’ quality of life. Therefore, the impact of research on different aspects of colonoscopy can be expected to have a considerable impact. In this March issue, Endoscopy is supporting the global initiative of Colorectal Cancer Awareness Month by carrying research reports that may especially contribute to the challenge against colorectal cancer.

Contributions from various countries on improving individual adherence and on increased awareness among screenees show that knowledge about attitudes and behaviours is relevant. This will lead to a greater focus on the quality of colonoscopy and on efforts to improve standard techniques of polypectomy and advanced endoscopic submucosal resection.

Two studies report on patients’ screening experiences and on attempts to improve those experiences. From England, a survey of more than 50 000 patients referred for colonoscopy after a positive fecal occult blood test is reported, and from Italy, an attempt to simplify bowel preparation, commonly described by patients as the most unpleasant part of the procedure, is described. An interesting study from Israel investigates the rarity of adenomatous polyps in patients with ulcerative colitis, and this is discussed further in an editorial.

Regarding the effectiveness of the clinicians, four studies, together with an ESGE Position Statement on reporting colonoscopy results, are aimed at improving colonoscopists’ performance and thus the quality of the service. The effects of specialization and of experience or training in adenoma detection are evident in two studies, from Spain and from the Netherlands. A French study found that the endoscopist was an independent risk factor for patients being referred for surgical resection of nonmalignant colorectal polyps. Interestingly, when colonoscopy withdrawal time was monitored among Swiss endoscopists their adenoma detection rates improved.

Finally, looking at the techniques and tools of colonoscopy, some exciting papers describe novel methods to facilitate endoscopic resection of problematic advanced lesions.

We hope you enjoy our March issue.

Mario Dinis-Ribeiro
Michael Bretthauer
Peter D. Siersema
on behalf of the Editors