Abstract
What is the probable effect of more sensitive diagnostic technology? Is an improved ability to visualise lesions at colonoscopy always better? Or are there downsides to consider? In The Lancet Oncology, Ian Gralnek and colleagues1 report findings from their randomised tandem comparison trial of standard forward-viewing colonoscopy versus full-spectrum endoscopy with a 330° field of view. In the 185 study participants, the proportion of adenomas missed was lower in patients in the full-spectrum endoscopy group than in those in the standard forward-viewing procedure group: five (7%) of 67 versus 20 (41%) of 49 adenomas missed (p<0·0001).
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