Abstract
Conventional colonoscopy misses some neoplastic lesions. We compared the sensitivity of chromoendoscopy and colonoscopy with intensive inspection for detecting adenomatous polyps missed by conventional colonoscopy. Fifty subjects with a history of colorectal cancer or adenomas underwent tandem colonoscopies at one of five centers of the Great Lakes New England Clinical Epidemiology and Validation Center of the Early Detection Research Network. The first exam was a conventional colonoscopy with removal of all visualized polyps. The second exam was randomly assigned as either pan-colonic indigocarmine chromoendoscopy or standard colonoscopy with intensive inspection lasting >20 minutes. Size, histology, and numbers of polyps detected on each exam were recorded. Twenty-seven subjects were randomized to a second exam with chromoendoscopy and 23 underwent intensive inspection. Forty adenomas were identified on the first standard colonoscopies. The second colonoscopies detected 24 additional adenomas: 19 were found using chromoendoscopy and 5 were found using intensive inspection. Chromoendoscopy found additional adenomas in more subjects than did intensive inspection (44% versus 17%) and identified significantly more missed adenomas per subject (0.7 versus 0.2, P < 0.01). Adenomas detected with chromoendoscopy were significantly smaller (mean size 2.66 ± 0.97 mm) and were more often right-sided. Chromoendoscopy was associated with more normal tissue biopsies and longer procedure times than intensive inspection. After controlling for procedure time, chromoendoscopy detected more adenomas and hyperplastic polyps compared with colonoscopy using intensive inspection alone. Chromoendoscopy detected more polyps missed by standard colonoscopy than did intensive inspection. The clinical significance of these small missed lesions warrants further study.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 507-513 |
| Number of pages | 7 |
| Journal | Cancer Prevention Research |
| Volume | 1 |
| Issue number | 7 |
| DOIs | |
| State | Published - Dec 2008 |
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All Science Journal Classification (ASJC) codes
- Oncology
- Cancer Research
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Chromoendoscopy detects more adenomas than colonoscopy using intensive inspection without dye spraying. / Stoffel, Elena M.; Turgeon, D. Kim; Stockwell, David H.; Normolle, Daniel P.; Tuck, Missy K.; Marcon, Norman E.; Baron, John A.; Bresalier, Robert S.; Arber, Nadir; Ruffin, MacK T.; Syngal, Sapna; Brenner, Dean E.
In: Cancer Prevention Research, Vol. 1, No. 7, 12.2008, p. 507-513.Research output: Contribution to journal › Article
TY - JOUR
T1 - Chromoendoscopy detects more adenomas than colonoscopy using intensive inspection without dye spraying
AU - Stoffel, Elena M.
AU - Turgeon, D. Kim
AU - Stockwell, David H.
AU - Normolle, Daniel P.
AU - Tuck, Missy K.
AU - Marcon, Norman E.
AU - Baron, John A.
AU - Bresalier, Robert S.
AU - Arber, Nadir
AU - Ruffin, MacK T.
AU - Syngal, Sapna
AU - Brenner, Dean E.
PY - 2008/12
Y1 - 2008/12
N2 - Conventional colonoscopy misses some neoplastic lesions. We compared the sensitivity of chromoendoscopy and colonoscopy with intensive inspection for detecting adenomatous polyps missed by conventional colonoscopy. Fifty subjects with a history of colorectal cancer or adenomas underwent tandem colonoscopies at one of five centers of the Great Lakes New England Clinical Epidemiology and Validation Center of the Early Detection Research Network. The first exam was a conventional colonoscopy with removal of all visualized polyps. The second exam was randomly assigned as either pan-colonic indigocarmine chromoendoscopy or standard colonoscopy with intensive inspection lasting >20 minutes. Size, histology, and numbers of polyps detected on each exam were recorded. Twenty-seven subjects were randomized to a second exam with chromoendoscopy and 23 underwent intensive inspection. Forty adenomas were identified on the first standard colonoscopies. The second colonoscopies detected 24 additional adenomas: 19 were found using chromoendoscopy and 5 were found using intensive inspection. Chromoendoscopy found additional adenomas in more subjects than did intensive inspection (44% versus 17%) and identified significantly more missed adenomas per subject (0.7 versus 0.2, P < 0.01). Adenomas detected with chromoendoscopy were significantly smaller (mean size 2.66 ± 0.97 mm) and were more often right-sided. Chromoendoscopy was associated with more normal tissue biopsies and longer procedure times than intensive inspection. After controlling for procedure time, chromoendoscopy detected more adenomas and hyperplastic polyps compared with colonoscopy using intensive inspection alone. Chromoendoscopy detected more polyps missed by standard colonoscopy than did intensive inspection. The clinical significance of these small missed lesions warrants further study.
AB - Conventional colonoscopy misses some neoplastic lesions. We compared the sensitivity of chromoendoscopy and colonoscopy with intensive inspection for detecting adenomatous polyps missed by conventional colonoscopy. Fifty subjects with a history of colorectal cancer or adenomas underwent tandem colonoscopies at one of five centers of the Great Lakes New England Clinical Epidemiology and Validation Center of the Early Detection Research Network. The first exam was a conventional colonoscopy with removal of all visualized polyps. The second exam was randomly assigned as either pan-colonic indigocarmine chromoendoscopy or standard colonoscopy with intensive inspection lasting >20 minutes. Size, histology, and numbers of polyps detected on each exam were recorded. Twenty-seven subjects were randomized to a second exam with chromoendoscopy and 23 underwent intensive inspection. Forty adenomas were identified on the first standard colonoscopies. The second colonoscopies detected 24 additional adenomas: 19 were found using chromoendoscopy and 5 were found using intensive inspection. Chromoendoscopy found additional adenomas in more subjects than did intensive inspection (44% versus 17%) and identified significantly more missed adenomas per subject (0.7 versus 0.2, P < 0.01). Adenomas detected with chromoendoscopy were significantly smaller (mean size 2.66 ± 0.97 mm) and were more often right-sided. Chromoendoscopy was associated with more normal tissue biopsies and longer procedure times than intensive inspection. After controlling for procedure time, chromoendoscopy detected more adenomas and hyperplastic polyps compared with colonoscopy using intensive inspection alone. Chromoendoscopy detected more polyps missed by standard colonoscopy than did intensive inspection. The clinical significance of these small missed lesions warrants further study.
UR - http://www.scopus.com/inward/record.url?scp=84873362347&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84873362347&partnerID=8YFLogxK
U2 - 10.1158/1940-6207.CAPR-08-0096
DO - 10.1158/1940-6207.CAPR-08-0096
M3 - Article
C2 - 19139000
AN - SCOPUS:84873362347
VL - 1
SP - 507
EP - 513
JO - Cancer Prevention Research
JF - Cancer Prevention Research
SN - 1940-6207
IS - 7
ER -