Standards of diagnostic colonoscopy for early‐stage neoplasia: Recommendations by an Asian private group

Abstract

Background and AimIn recent years, the incidence of colorectal cancer has been increasing, and it is now becoming the major cause of cancer death in Asian countries. The aim of the present study was to develop Asian expert‐based consensus to standardize the preparation, detection and characterization for the diagnosis of early‐stage colorectal neoplasia.MethodsA professional group was formed by 36 experts of the Asian Novel Bio‐Imaging and Intervention Group (ANBI2G) members. Representatives from 12 Asia–Pacific countries participated in the meeting. The group organized three consensus meetings focusing on diagnostic endoscopy for gastrointestinal neoplasia. The Delphi method was used to develop the consensus statements.ResultsThrough the three consensus meetings with debating, reviewing the literature and regional data, a consensus was reached at third meeting in 2016. The consensus was reached on a total of 10 statements. Summary of statements is as follows: (i) Adequate bowel preparation for high‐quality colonoscopy; (ii) Antispasmodic agents for lesion detection; (iii) Image‐enhanced endoscopy (IEE) for polyp detection; (iv) Adenoma detection rate for quality indicators; (v) Good documentation of colonoscopy findings; (vi) Complication rates; (vii) Cecal intubation rate; (viii) Cap‐assisted colonoscopy (CAC) for polyp detection; (ix) Macroscopic classification using indigocarmine spray for characterization of colorectal lesions; and (x) IEE and/or magnifying endoscopy for prediction of histology.ConclusionThis consensus provides guidance for carrying out endoscopic diagnosis and characterization for early‐stage colorectal neoplasia based on the evidence. This will enhance the quality of endoscopic diagnosis and improve detection of early‐stage colorectal neoplasia.

Comparison of the effect of regular diet and low-fiber diet on bowel cleansing before colonoscopy

“…The quality of bowel preparation plays a fundamental role in performing a high-quality colonoscopy to observe the colon mucosa [14]. Despite of the various methods for bowel preparation, the rates of inadequate bowel preparation are recorded to be between 20% and 30% [15,16].…”

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

“…28 Moreover, all flat elevated lesions ≥10 mm, except serrated lesions, were classified as either laterally spreading tumour, non-granular type (LST-NG) or granular type (LST-G). [29][30][31] The lesion size was calibrated by comparisons with the closed cups of a biopsy forceps (approximately 2.5 mm). All detected lesions diagnosed as neoplastic lesions and right-sided large serrated lesions≥10 mm were removed endoscopically.…”

“…Due to the high-quality colonoscopies performed by experienced endoscopists, which enabled the accurate detection of flat lesions, this study clearly showed that over 60% of detected AN were morphologically NP-CRNs, and over 80% of them were classified as LST-NG lesions. [29][30][31] Considering such a high proportion of LST-NG among detected AN and the wellknown fact that LST-NG has an easily-overlooked appearance and different oncogenic mutations in KRAS, BRAF or PIK3CA from polypoid lesions, [34][35][36] it can be postulated that LST-NG may be an important precursor of PCCRC. The relatively high proportion of LST-NG detected in the right-sided colon in this study is also in agreement with the fact that many PCCRCs are located in the right-sided colon.…”

Objective evaluation of the visibility of colorectal lesions using eye tracking

“…The video endoscopic system (LASEREO; Fujifilm Co.) and high-definition colonoscopes (EC-L590ZP, EC-L600ZP, and EC-L600ZP7; Fujifilm Co.) were used. Previously, the abbreviation of BLI has been used for two different words: blue laser imaging 18 and blue light imaging 19 . In this study, we noted BLI as blue laser imaging.…”