Improvement in the Adenoma Detection Rate with High Definition Colonoscopes (HD-C)

Abstract

Purpose: Development of high definition endoscopes has been a recent technological advancement in endoscopic imaging. Whether these improve adenoma detection rates during screening colonoscopies(SC) is not clear. The aim of the study was to compare standard definition colonoscopes(SD-C) and HD-C for: 1. Proportion of subjects with adenomas and number of adenomas detected per subject. 2. Proportion of subjects with advanced adenomas and number of advanced adenomas detected per subject. 3. Proportion of subjects with right sided adenomas and number of right sided adenomas detected per subject. Methods: We conducted a retrospective review of all SC performed at a tertiary referral center during two different time periods by 4 experienced endoscopists with or without a trainee. Between Jan 2005 and Dec 2006, all SC were performed with SD-C (Olympus 140 and 160 series) and were included in the SD-C arm. After HD-C (Olympus 180 series) were acquired by our unit, the older generation colonoscopes were phased out. All SC performed with HD-C between Jan 2008 to Sep 2010 were included in the HD-C arm. Detailed review of the patient records, endoscopy reports and histology reports was conducted. Fisher's exact test, unpaired t test and Wilcoxon rank sum test were used for statistical analysis. Results: A total of 2,015 SC were reviewed; 1056 in SD-C arm and 959 in HDC arm. Mean age was higher in the SD-C arm compared to HD-C arm (60.4 yrs vs 58.5 yrs; p <0.001). There were higher number of males in SD-C arm (98% vs 96%; p = 0.002). 74% subjects in SD-C arm were Caucasians compared to 71% in HD-C arm (p = 0.06). There were no significant differences between the two groups with respect to the inadequacy of bowel prep (p>0.99). The proportion of subjects with adenomas, number of adenomas per subject, proportion of subjects with advanced adenomas, number of advanced adenomas per subject, proportion of subjects with right sided adenomas and right sided adenomas per subject are shown in the Table.Table: No Caption available.Conclusion: 1. HD-C detected a 10% higher number of subjects with adenomas and a 41% higher number of adenomas per subject. 2. HD-C also detected a significantly higher number of advanced adenomas and right sided adenomas. 3. HD-C is a significant advancement in endoscopic imaging that can improve adenoma detection rates and may have a positive impact on the effectiveness of colonoscopy in preventing colorectal cancer. Disclosure: Deepthi Rao - No financial relationship with Olympus. Neil Gupta - No financial relationship with Olympus. Prateek Sharma - Olympus Grant / Research support. Ajay Bansal - No financial relationship with Olympus. Amit Rastogi - Olympus Grant / Research support.