Inspection During Colonoscope Insertion Provides No Added Benefit
Major Finding: At least one adenoma was detected in 52% of patients who underwent inspection during instrument insertion, compared with 58% of patients who were inspected only during instrument withdrawal.
Data Source: Randomized trial in 340 patients undergoing routine screening or surveillance colonoscopy.
Disclosures: Dr. Hewett disclosed consulting for Olympus America. Dr. Rex reported numerous financial relationships with industry, including salary from Olympus America. Dr. Sanaka disclosed no conflicts; three of his coauthors disclosed financial relationships with Boston Scientific, Olympus America, Myriad Genetics, Pfizer, Salix Pharmaceuticals, and Takeda Pharmaceuticals. Dr. Coyle reported a financial relationship with Takeda Pharmaceuticals.
FROM THE ANNUAL DIGESTIVE DISEASE WEEK
During the same session at DDW about colonoscopy techniques, researchers reported survey results indicating that endoscopists who remove all polyps irrespective of size during insertion and those who remove only small polyps less than 5 mm in size during insertion had higher adenoma detection rates, compared with those who remove polyps only during withdrawal (28.7% vs. 25% vs. 16.7%; P = .045). Similarly, their proximal adenoma detection rates were also higher (17.5% vs. 16.5% vs. 9%; P = .02), said Dr. Madhusudhan Sanaka of the Cleveland Clinic. The 19-item survey was completed in 2010 by a multispecialty group of 42 endoscopists including 29 gastroenterologists, 7 colorectal surgeons, 5 general surgeons, and 1 primary care physician. Their mean age was 61 years; 49.5% were male. In all, 21% removed all polyps during insertion, 55% removed polyps measuring less than 5 mm on insertion, and 24% removed polyps only upon withdrawal, Dr. Sanaka said.
Dr. Hewett disclosed consulting for Olympus America. Dr. Rex receives research support from Olympus America and is on their speakers bureau; he had no other relevant disclosures. Dr. Sanaka disclosed no conflicts; three of his coauthors disclosed financial relationships with Boston Scientific, Olympus America, Myriad Genetics, Pfizer, Salix Pharmaceuticals and Takeda Pharmaceuticals. Dr. Coyle reported a financial relationship with Takeda Pharmaceuticals.
