Colon Polyps Clinical Trial
Official title:
RIGHT SIDED COLON POLYP MISS RATE: IMPACT OF RETROFLEXION IN THE RIGHT COLON
Colonoscopy is the gold standard screening test for colorectal cancer. Removal of
pre-malignant colon polyps during colonoscopy reduces colorectal cancer mortality by over
50%. However, while colonoscopy is highly effective at preventing distal (left sided) colon
cancers, it provides only limited protection from cancer in the proximal (right side) colon.
Our goal is to determine if additional pre-cancerous colon polyps can be identified by
looking at the right side of the colon in retroflexion. During retroflexion the tip of the
colonoscope is turned 180 degrees; allowing the doctor to view the backs of colonic folds. If
additional polyps can be identified in this manner colonoscopy will become a more efficient
method of screening for colon cancer.
In order to evaluate how effective right colon retroflexion is at detecting polyps in the
proximal colon we plan on performing a randomized, controlled trial. Patients undergoing
screening or follow up colonoscopy will be invited to participate in the study. Those
patients who agree to participate will be randomized into one of two groups once the
colonoscope is fully inserted. Group one will have the right side of their colon examined for
polyps with the endoscope looking forward (traditional form of examination) followed by
repeat examination of the right side of the colon with the colonosocpe in retroflexion
(looking backwards). Polyps seen during each section of the exam will be removed and manner
in which the polyps were found/ removed will be recorded. Following the two exams of the
right side of the colon the colonoscopy will be completed in the usual manner. The duration
of each portion of colonoscopy will be recorded. After the procedure is completed the
physician performing the colonoscopy will rate difficulty of the procedure and confidence
with quality of the examination. Pathology results for each polyp will be recorded once
available. There will be no study related follow up after the pathology results are recorded.
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