Miss rate of polyps has been shown to be substantially lower with full-spectrum endoscopy compared with standard forward-viewing colonoscopy in a tandem study at per polyp analysis.
However, there is uncertainty on whether full-spectrum endoscopy is also associated with a higher detection rate of colorectal neoplasia, especially advanced lesions, in per patient analysis.
Dr Cesare Hassan and colleagues evaluated consecutive subjects undergoing colonoscopy following a positive fecal immunochemical test (FIT) by experienced endoscopists, performed in the context of a regional colorectal cancer population-screening program.
|Detection rates of adenomas were 44% in the full-spectrum endoscopy arm|
The participants were randomized between colonoscopy with either full-spectrum endoscopy or standard forward-viewing colonoscopy in 7 Italian centers.
Randomization was stratified by gender, age group and screening history.
The researchers' primary outcomes included detection rates of advanced adenomas, adenomas, and sessile-serrated polyps.
Of 741 eligible subjects, 658 were randomized to either full-spectrum endoscopy or standard forward-viewing colonoscopy and included in the analysis.
Overall, the research team found that 293/658 and 143/658 subjects had at least one adenoma, and advanced adenoma, respectively, while sessile-serrated polyps was the most advanced lesion in 18 cases.
Detection rates of adenomas and advanced adenomas were 44% and 20% in the full-spectrum endoscopy arm, and 46% and 24% in the standard forward-viewing arm, with no difference for detection rates of adenomas and advanced adenomas.
The researchers detected no difference in sessile-serrated polyps or multiplicity between the 2 arms.
In the per polyp analysis, the team noted that the mean number of adenomas and proximal adenomas per patient was 0.81 and 0.47 in the full-spectrum endoscopy arm, and 0.85 and 0.48 in the standard forward-viewing colonoscopy arm.
Dr Hassan's team comments, "We found no statistically significant difference in detection rates of advanced adenomas or adenomas between full-spectrum endoscopy and standard forward-viewing patients."