K E van Keulen1, E Soons1, P D Siersema2. 1. Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands. 2. Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands. Peter.Siersema@radboudumc.nl.
Abstract
PURPOSE OF REVIEW: Colorectal cancer is one of the most common malignancies in the Western world and is thought to develop from premalignant polyps. Over the past decade, several behind folds visualizing techniques (BFTs) have become available to improve polyp detection. This systematic review and meta-analysis aims to compare BFTs with conventional colonoscopy (CC). RECENT FINDINGS: In the past five years, 14 randomized controlled trials (RCTs) including 8384 patients comparing different BFTs with CC were published. The overall relative risks for adenoma detection rate, polyp detection rate, and adenoma miss rate comparing BFTs with CC were 1.04 (95% confidence interval [CI] 0.98-1.10; P = 0.15), 1.03 (95% CI 0.98-1.09; P = 0.28), and 0.70 (95% CI 0.46-1.05; P = 0.08), respectively. Other quality metrics for colonoscopy were not significantly different between BFT-assisted colonoscopy and CC either. This meta-analysis of RCTs published in the past five years does not show a significant benefit of BFTs on any of the important quality metrics of colonoscopy. The lack of additional effect of BFTs might be due to improved awareness of colonoscopy quality metrics and colonoscopy skills among endoscopists combined with improvements of conventional colonoscope technology.
PURPOSE OF REVIEW: Colorectal cancer is one of the most common malignancies in the Western world and is thought to develop from premalignant polyps. Over the past decade, several behind folds visualizing techniques (BFTs) have become available to improve polyp detection. This systematic review and meta-analysis aims to compare BFTs with conventional colonoscopy (CC). RECENT FINDINGS: In the past five years, 14 randomized controlled trials (RCTs) including 8384 patients comparing different BFTs with CC were published. The overall relative risks for adenoma detection rate, polyp detection rate, and adenoma miss rate comparing BFTs with CC were 1.04 (95% confidence interval [CI] 0.98-1.10; P = 0.15), 1.03 (95% CI 0.98-1.09; P = 0.28), and 0.70 (95% CI 0.46-1.05; P = 0.08), respectively. Other quality metrics for colonoscopy were not significantly different between BFT-assisted colonoscopy and CC either. This meta-analysis of RCTs published in the past five years does not show a significant benefit of BFTs on any of the important quality metrics of colonoscopy. The lack of additional effect of BFTs might be due to improved awareness of colonoscopy quality metrics and colonoscopy skills among endoscopists combined with improvements of conventional colonoscope technology.
Entities:
Keywords:
Adenoma detection rate; Adenoma miss rate; Behind folds visualizing technique; Cap-assisted colonoscopy; Colorectal cancer; EndoRings; Endocuff Vision; Extra Wide Angle View (EWAVE); Full Spectrum Endoscopy (FUSE); G-Eye; Meta-analysis; Scope retroflexion; Systematic review; Third Eye Panoramic cap; Third Eye Retroscope
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