Narrow-Band Imaging for Detection of Neoplasia at Colonoscopy: A Meta-analysis of Data From Individual Patients in Randomized Controlled Trials

Atkinson, Nathan; Ket, Shara; Bassett, Paul; Aponte, Diego; Aguiar, Silvia De; Gupta, Neil; Horimatsu, Takahiro; Ikematsu, Hiroaki; Inoue, Takuya; Kaltenbach, Tonya; Leung, Wai K.; Matsuda, Takahisa; Paggi, Silvia; Radaelli, Franco; Rastogi, Amit; Rex, Douglas K.; Sabbagh, Luis; Saito, Yutaka; Sano, Yasushi; Saracco, Giorgio Maria; Saunders, Brian P.; Senore, Carlo; Soetikno, Roy; Vemulapalli, Krishna C.; Jairath, Vipul; East, James E.

doi:10.1053/j.gastro.2019.04.014

Cited by 129 publications

(98 citation statements)

References 41 publications

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“…In addition to the effort by endoscopists, further development of endoscopic technologies such as image-enhanced endoscopy and artificial intelligence is warranted. [41][42][43][44][45] Although the non-inferiority of the 3-year surveillance colonoscopy compared with 1-year and 3-year surveillance colonoscopies in terms of effectively detecting AN was confirmed in this study, it does not indicate that every patient should uniformly undergo surveillance colonoscopy 3 years after polypectomy. On the basis of the extremely low incidence of AN observed in this study, it may be possible to prolong the surveillance intervals for patients with a low risk of incidence of metachronous AN.…”

Section: Endoscopycontrasting

confidence: 50%

Randomised comparison of postpolypectomy surveillance intervals following a two-round baseline colonoscopy: the Japan Polyp Study Workgroup

Matsuda

Fujii²,

Sano³

et al. 2020

Gut

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ObjectiveTo assess whether follow-up colonoscopy after polypectomy at 3 years only, or at 1 and 3 years would effectively detect advanced neoplasia (AN), including nonpolypoid colorectal neoplasms (NP-CRNs).DesignA prospective multicentre randomised controlled trial was conducted in 11 Japanese institutions. The enrolled participants underwent a two-round baseline colonoscopy (interval: 1 year) to remove all neoplastic lesions. Subsequently, they were randomly assigned to undergo follow-up colonoscopy at 1 and 3 years (2-examination group) or at 3 years only (1-examination group). The incidence of AN, defined as lesions with low-grade dysplasia ≥10 mm, high-grade dysplasia or invasive cancer, at follow-up colonoscopy was evaluated.ResultsA total of 3926 patients were enrolled in this study. The mean age was 57.3 (range: 40–69) years, and 2440 (62%) were male. Of these, 2166 patients were assigned to two groups (2-examination: 1087, 1-examination: 1079). Overall, we detected 29 AN in 28 patients at follow-up colonoscopy in both groups. On per-protocol analysis (701 in 2-examination vs 763 in 1-examination group), the incidence of AN was similar between the two groups (1.7% vs 2.1%, p=0.599). The results of the non-inferiority test were significant (p=0.017 in per-protocol, p=0.001 in intention-to-treat analysis). NP-CRNs composed of dominantly of the detected AN (62%, 18/29), and most of them were classified into laterally spreading tumour non-granular type (83%, 15/18).ConclusionAfter a two-round baseline colonoscopy, follow-up colonoscopy at 3 years detected AN, including NP-CRNs, as effectively as follow-up colonoscopies performed after 1 and 3 years.

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Section: Endoscopycontrasting

confidence: 50%

Randomised comparison of postpolypectomy surveillance intervals following a two-round baseline colonoscopy: the Japan Polyp Study Workgroup

Matsuda

Fujii²,

Sano³

et al. 2020

Gut

Self Cite

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“…21 A subsequent metaanalysis of NBI for detection of non-adenomatous (serrated) lesions suggested significantly improved detection with either first or second generation "Bright" NBI. 22 With increasing use of NBI, the Workgroup on Serrated Polyps and Polyposis (WASP)-has described classification (also called WASP) for distinguishing between hyperplastic and adenomatous/serrated polyps ( Fig. 1).…”

Section: Sessile Serrated Polyps and Their Endoscopic Detectionmentioning

confidence: 99%

Optimal Endoscopic Treatment and Surveillance of Serrated Polyps

Gupta

East

2020

Gut and Liver

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Serrated polyps are considered precursor lesions that account for 15% to 30% of colorectal cancers, and they are overrepresented as a cause of interval cancers. They are difficult to detect and resect comprehensively; however, recent data suggest that high definition endoscopy, chromoendoscopy (via spray catheter, pump or orally), narrow band imaging, split-dose bowel preparation and a slower withdrawal (>6 minutes) can all improve detection. Cold snare resection is effective and safe for these lesions, including cold snare piecemeal endoscopic mucosal resection, which is likely to become the standard of care for lesions >10 mm in size. Sessile serrated lesions ≥10 mm in size, those exhbiting dysplasia, or traditional serrated adenomas increase the chance of future advanced neoplasia. Thus, a consensus is emerging: a surveillance examination at 3 years should be recommended if these lesions are detected. Serrated lesions likely carry equivalent risk to adenomas, so future guidelines may consider serrated class lesions and adenomas together for risk stratification. Patients with serrated polyposis syndrome should undergo surveillance every 1 to 2 years once the colon is cleared of larger lesions, and their first degree relatives should undergo screening every 5 years starting at age 40.

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“…These are all adjuncts, which are known to improve ADR independent of add‐on devices. Simple uncostly educational interventions (use of anti‐spasmodics, position changes, and rectal retroflexion) may provide more benefit, particularly in endoscopists with lower ADRs, and narrow‐band imaging is another inexpensive method to improve ADR . With this in mind, it would have been interesting had the authors stratified their results by endoscopist experience level, although with four apparently high level endoscopists, it may require a more diverse group to show a significant difference in this respect.…”

Section: Published Parallel Group Randomized Controlled Trials Involvmentioning

confidence: 99%

Distal attachments for adenoma detection go head‐to‐head: Cap or cuff?

Lahiff

East

2019

J of Gastro and Hepatol

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Narrow-Band Imaging for Detection of Neoplasia at Colonoscopy: A Meta-analysis of Data From Individual Patients in Randomized Controlled Trials

Cited by 129 publications

References 41 publications

Randomised comparison of postpolypectomy surveillance intervals following a two-round baseline colonoscopy: the Japan Polyp Study Workgroup

Randomised comparison of postpolypectomy surveillance intervals following a two-round baseline colonoscopy: the Japan Polyp Study Workgroup

Optimal Endoscopic Treatment and Surveillance of Serrated Polyps

Distal attachments for adenoma detection go head‐to‐head: Cap or cuff?

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