Full-spectrum endoscopy trumps standard colonoscopy

Full-spectrum endoscopy offers a technological advancement for colonoscopy as it could improve the efficacy of colorectal cancer screening and surveillance, according to a study published in the March issue of the Lancet Oncology.

Though colonoscopy is the go-to modality for colorectal adenoma and cancer detection, the technology is not perfect. Improvement of colonoscopy technique and imaging capability could prevent oversight of interval colorectal cancer. Lead author Ian M. Gralnek, MD, of the Rambam Health Care Campus in Haifa, Israel, and colleagues compared the adenoma miss rates from full-spectrum endoscopy colonoscopy with those of standard forward-viewing colonoscopy.

The researchers conducted per-protocol analyses of 185 patients who underwent same-day, back-to-back standard colonoscopy and full-spectrum endoscopy colonoscopy. Random assignment placed 88 participants in a group to receive standard forward-viewing colonoscopy first and 97 were randomly put into a group that would undergo full-spectrum endoscopy colonoscopy first.

The study’s findings indicated that the adenoma miss rate was significantly lower in patients in the full-spectrum endoscopy group than the standard colonoscopy group. With endoscopy, five of 67 adenomas were missed, which was 7 percent. Colonoscopy, however, missed 42 percent, or 20 of 49 adenomas. Of those 20 missed adenomas, three were advanced. Conversely, none of the five missed adenomas with endoscopy were advanced.

“These data suggest that full-spectrum colonoscopy improves visualization of the colonic mucosa during colonoscopy and could improve the efficacy of screening of colorectal cancer and surveillance colonoscopy,” wrote Gralnek and colleagues.