Screening colonoscopy can prevent cancer by removal of adenomatous polyps.
Recent evidence suggests that insufficient time for inspection during overly rapid colonoscope withdrawal may compromise adenoma detection.
Dr Robert Barclay and colleagues from Illinois, USA conducted a study of the effect of a minimum prespecified time for screening colonoscopy.
Baseline data consisted of neoplasia detection rates during 2053 screening colonoscopies performed without a specified withdrawal protocol.
|25% of advanced neoplastic lesions detected in examinations were 9 mm or less in diameter|
|Clinical Gastroenterology & Hepatology|
The team performed during a subsequent 13-month period 2325 screening colonoscopies using dedicated inspection techniques and a minimum 8-minute withdrawal time.
The team compared overall and individual rates of neoplasia detection in postintervention procedures with those in baseline examinations.
The researchers found as compared with baseline subjects, postintervention subjects had higher rates of any neoplasia, and of advanced neoplastic lesions per patient screened.
The team noted that 25% of advanced neoplastic lesions detected in postintervention examinations were 9 mm or less in diameter, versus 10% in baseline examinations.
Endoscopists with mean withdrawal times of 8 minutes or longer had higher rates of detection of any neoplasia.
The research team found that endoscopists with mean withdrawal times of 8 minutes or longer of advanced neoplasia.
Dr Barclay’s team concluded, “After implementing a protocol of careful inspection during a minimum of 8 minutes to withdraw the colonoscope, we observed significantly greater rates of overall and advanced neoplasia detection during screening colonoscopy.”