Retroflexion, a costless endoscopic maneuver, increases adenoma detection rate in the ascending colon

Michopoulos, Spyridon; Axiaris, Georgios; Baxevanis, Panagiotis; Stoupaki, Maria; Gkagkari, Vassiliki; Leonidakis, Georgios; Zampeli, Evanthia; Sotiropoulou, Maria; Petraki, Kalliopi

doi:10.20524/aog.2020.0549

Cited by 4 publications

(1 citation statement)

References 43 publications

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“…ADR at colonoscopy is crucial: Corley et al [43] demonstrated that every 1% increase in ADR was associated with a 3% decrease in CRC risk. Techniques to increase right-sided ADR at colonoscopy are key to reducing the incidence of proximal CRC, such as second forward view and retroflexion in the ascending colon [44,45]. Longer withdrawal time [46], distal attachment devices [47] and artificial intelligence [48] are all also proven to increase ADR and therefore the quality of colonoscopy.…”

Section: Discussionmentioning

confidence: 99%

Colorectal cancer incidence trends by tumour location among adults of screening‐age in England: a population‐based study

et al. 2023

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AimProximal and distal colorectal cancers (CRCs) exhibit different clinical, molecular and biological patterns. The aim of this study was to determine temporal trends in the age‐standardized incidence rates (ASIRs) of proximal and distal CRC following the introduction of the English Bowel Cancer Screening Programme (BCSP) in 2006.MethodThe National Cancer Registration and Analysis Service database was used to identify incident cases of CRC among adults of screening age (60–74 years) between 2001 and 2017. ASIRs were calculated using the European Standard Population 2013 and incidence trends analysed by anatomical subsite (proximal, caecum to descending colon; distal, sigmoid to rectum), sex and Index of Multiple Deprivation (IMD) quintile using Joinpoint regression software.ResultsBetween 2001 and 2017, 541 515 incident cases of CRC were diagnosed [236 167 proximal (43.6%) and 305 348 distal (56.4%)]. A marginal reduction in the proximal ASIR was noted from 2008 [annual percentage change (APC) −1.4% (95% CI −2.0% to −0.9%)] compared with a greater reduction in distal ASIR from 2011 to 2014 [APC −6.6% (95% CI −11.5% to −1.5%)] which plateaued thereafter [APC −0.5% (95% CI −3.2% to 2.2%)]. Incidence rates decreased more rapidly in men than women. Adults in IMD quintiles 4–5 experienced the greatest reduction in distal tumours [APC −3.5% (95% CI −4.3% to −2.7%)].ConclusionFollowing the introduction of the English BCSP, the incidence of CRC has subsequently reduced among adults of screening age, with this trend being most pronounced in distal tumours and in men. There is also evidence of a reduction in the deprivation gap for distal tumour incidence. Strategies to improve the detection of proximal tumours are warranted.

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Section: Discussionmentioning

confidence: 99%

Colorectal cancer incidence trends by tumour location among adults of screening‐age in England: a population‐based study

et al. 2023

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Low Colon Capsule Endoscopy (CCE) False Negative Rate for Polyps Excluding Reader Error

Semenov

Costigan

et al. 2022

Diagnostics

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Background: CCE is a diagnostic tool lacking clinical data on false negative rates. We aimed to assess this rate and the reader/technical error breakdown. Methods: False negative CCEs were identified after comparing to a colonoscopy database. Missed pathology characteristics and study indications/quality were collated. Cases were re-read by experts and newly identified lesions/pathologies were verified by an expert panel and categorised as reader/technical errors. Results: Of 532 CCEs, 203 had an adequately reported comparative colonoscopy, 45 (22.2%) had missed polyps, and 26/45 (57.8%) reached the colonic section with missed pathology. Of the cases, 22 (84.6%) had adequate bowel preparation. Indications included 13 (50%) polyp surveillance, 12 (46%) GI symptoms, 1 (4%) polyp screening. CCE missed 18 (69.2%) diminutive polyps and 8 (30.8%) polyps ≥ 6 mm, 18/26 (69.2%) of these were adenomas. Excluding incomplete CCE correlates, colonoscopy total and significant polyp yield were 97/184 (52.7%) and 50/97 (51.5%), respectively. CCE total polyp and significant polyp false negative rate was 26.8% (26/97) and 16% (8/50), respectively. Following re-reading, reader and technical error was 20/26 (76.9%) and 6/26 (23.1%). Total and significant missed polyp rates were 20.6% (20/97) and 14% (7/50) for reader error, 6.2% (6/97) and 2% (1/50) for technical error. Conclusions: False negative CCE rate is not insubstantial and should be factored into clinical decision making.

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Unlocking quality in endoscopic mucosal resection

Keating¹,

Leyden²,

O’Connor³

et al. 2023

World J Gastrointest Endosc

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Retroflexion, a costless endoscopic maneuver, increases adenoma detection rate in the ascending colon

Cited by 4 publications

References 43 publications

Colorectal cancer incidence trends by tumour location among adults of screening‐age in England: a population‐based study

Colorectal cancer incidence trends by tumour location among adults of screening‐age in England: a population‐based study

Low Colon Capsule Endoscopy (CCE) False Negative Rate for Polyps Excluding Reader Error

Unlocking quality in endoscopic mucosal resection

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