Colonic Polyps Clinical Trial
Official title:
Efficacy of Segmental Examination Twice of Proximal Colon on Adenoma Detection: a Prospective, Randomized, Controlled Study
Segmental examination twice of the proximal colon might be helpful to increase adenoma detection rate (ADR).
Colonoscopy is the gold standard screening test for colorectal cancer (CRC). Removal of
adenomas can reduce the incidence and mortality of CRC. However, there is evidence that some
patients may develop interval cancers—cancers developed within 3-5 years following
colonoscopy and polypectomy. The overall rate of interval cancer was 1.1-2.7 per 1000
person-years. Several studies have suggested that patients who develop interval cancers are
more likely to have proximal compared than distal cancers.
One hypothesis is that adenomas may be more likely to be missed in the proximal colon
compared with the distal colon. Serrated polyps and some adenomas in the proximal colon may
be difficult to detect if they are flat, covered with mucus, or behind folds. A second
hypothesis is that neoplastic lesions of the proximal colon may biologically differ from
distal lesions and progress to malignancy with a short dwell time.
Several tandem back to back colonoscopy studies have demonstrated that up to 27% adenomas in
the proximal colon are missed during routine screening colonoscopy. Hover, examining the
colon twice as that in the back to back studies is difficult to be performed in clinical
practice. Thus, we developed a novel colonoscopy technique, segmental examination twice of
the proximal colon, that is simple and easy to be performed. The current study aims to
examine the efficacy of segmental examination twice of the proximal colon on adenoma
detection rate (ADR) during routine screening and surveillance colonoscopy.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Single Blind (Subject), Primary Purpose: Prevention
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