Colorectal Cancer Screening for the Serrated Pathway

Anderson, Joseph C.; Srivastava, Amitabh

doi:10.1016/j.giec.2020.02.007

Cited by 16 publications

(17 citation statements)

References 113 publications

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“…However, there is growing evidence that a mean CWT of 6–7 min has significant adenoma miss rates and a lower rate of sessile serrated adenoma detection 8,9,31,34 . These findings have been supported by numerous studies revealing that longer CWT would lead to increased ADR 7,11,20–22,30,31 . This systematic review and meta‐analysis analysis illustrate that increasing the CWT from 6 to 9 min or longer significantly improves the ADR and SDR.…”

Section: Discussionmentioning

confidence: 67%

“…reported that the cohort with the second look in the right colon led to a slightly longer withdrawal time 28 . This suggests that performing an adequate look may take more time and thus, prolonging the CWT would lead to an increase in detection of serrated polyps 8,9,30,31 …”

Section: Discussionmentioning

confidence: 99%

“…The current professional society guidelines recommend a mean CWT of 6 min 3,5,6 . However, there is growing evidence that a mean CWT of 6–7 min has significant adenoma miss rates and a lower rate of sessile serrated adenoma detection 8,9,31,34 . These findings have been supported by numerous studies revealing that longer CWT would lead to increased ADR 7,11,20–22,30,31 .…”

Section: Discussionmentioning

confidence: 99%

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A comparison of 9‐min colonoscopy withdrawal time and 6‐min colonoscopy withdrawal time: A systematic review and meta‐analysis

Bhurwal

Rattan

Sarkar

et al. 2021

J of Gastro and Hepatol

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Introduction The optimal colonoscopy withdrawal time is still a controversial topic. While several studies demonstrate that longer withdrawal time improves adenoma detection rate, others have contradicted these findings. Methods Three independent reviewers performed a comprehensive review of all original articles published from inception to January 2021 and included studies reporting comparison of the two cohorts—(i) ≥ 6 but less than 9 min of colonoscopy withdrawal time (CWT) and (ii) ≥ 9 min of CWT. The outcome measures were the following: (i) adenoma detection rate (ADR), (ii) advanced ADR, and (iii) sessile serrated adenoma detection rate (SDR). The meta‐analysis was performed, and the statistics were two‐tailed. Results A total of seven studies met the inclusion criteria after a thorough search of the literature was completed. The analysis revealed that ≥ 9 min of CWT had significantly higher odds of adenoma detection as compared with 6–9 min of CWT (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.30–1.82; I2 = 93.7). Additionally, a significantly higher odds of sessile serrated adenoma detection (OR 1.68, 95% CI 1.28–2.22; I2 = 0) and a trend towards higher odds of advanced adenoma detection (OR 1.38, 95% CI 0.98–1.95, I2 = 90) were seen with CWT of at least 9 min when compared with 6–9 min of CWT. Conclusion This systematic review and meta‐analysis analysis provides further evidence that at least 9 min of CWT cohort had significantly higher ADR and SDR as compared with the at least 6 min but less than 9 min of cohort.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A comparison of 9‐min colonoscopy withdrawal time and 6‐min colonoscopy withdrawal time: A systematic review and meta‐analysis

Bhurwal

Rattan

Sarkar

et al. 2021

J of Gastro and Hepatol

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“…7 Serrated lesions in the right colon may contribute to this problem because of their fleshy appearance and mucus cap, which make them less readily visible, especially if adequate time is not spent clearing and examining the colon. 8 Failure to detect polyps must be minimized to realize the full benefit of colonoscopy and provide the best patient outcomes. The question then becomes, given a negative screening colonoscopy with a good preparation, what is the optimal WT that allows sufficiently careful examination of the colorectal mucosa?…”

mentioning

confidence: 99%

Withdrawal Time: Is Nine the New Six?

Butterly

2022

Clinical Gastroenterology and Hepatology

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“…We now recognize that HPs are a subset of a larger group known as serrated polyps (SPs), which may account for 30% of all colorectal cancers (CRCs). 1,2 In addition to HPs, SPs include traditional serrated adenomas (TSAs) and sessile serrated polyps (SSPs). Our understanding of malignant risk for these polyps has evolved as well; we know that TSAs have cytologic dysplasia and that dysplasia can develop in SSPs.…”

mentioning

confidence: 99%