Detection Rate Of Colorectal Polyps Research Articles

Analysis of clinical and endoscopic characteristics of colorectal polyps in children

To analyze the clinical and endoscopic characteristics of colorectal polyps in children, and to explore the detection rate, age and gender distribution characteristics, endoscopic treatment effect and follow-up monitoring of colorectal polyps in children, so as to provide reference for disease management of colorectal polyps in children. The clinical and endoscopic characteristics of children with colorectal polyps in Xi 'an Children's Hospital from January 2019 to December 2019 were retrospectively analyzed. The patients were divided into 5 groups according to age (y): 0<y<1 years, 1≤ y<4 years, 4≤ y<7 years, 7≤ y<12 years, and 12≤ y ≤18 years. Independent sample t test, Pearson Chi-square test (χ2) were used to compare groups' differences. The results showed that a total of 724 colonoscopies were completed in 2019, and 160 colorectal polyps were diagnosed, with a detection rate of 22.10%. Among the children with colorectal polyps, 105 were males, accounting for 65.62%, and 55 were females, accounting for 34.38%. The detection rate of male colorectal polyps was 22.68%, and the detection rate of female colorectal polyps was 21.08%. There was no significant difference in the detection rate of colorectal polyps between males and females (χ2 = 0.25, P =0.617). Children with colorectal polyps were most common in the age group of 1≤ y<4 years, 72 cases, accounting for 41.14%(72/175). The detection rate of colorectal polyps in different age groups was statistically significant (χ2=73.929, P<0.05). The main symptom of children with colorectal polyps was hematochezia, accounting for 87.5% (140/160). Colorectal polyps were mainly single polyps in 140 patients, accounting for 87.50%, 15 patients had 2-4 polyps, accounting for 9.38%, and 5 patients had 5 or more polyps, accounting for 3.12%. A total of 210 polyps were removed, and the most common site of polyps was rectum, 123 polyps, accounting for 58.57% (123/210). 111 (52.86%, 111/210) of them were 1 cm to 2 cm in diameter. The Yamada classification was mainly type Ⅲ, 114 pieces, accounting for 54.29% (114/210). Among the 210 polyps with diameter ≥0.5 cm, 165 were removed by endoscopic mucosal resection, accounting for 78.57% (165/210). There were 23 patients with postoperative complications, including hematochezia, abdominal pain, fever, vomiting, diarrhea, dizziness, and no gastrointestinal perforation. Juvenile polyps were the main pathological type, accounting for 88.13% (141/160). The children with juvenile polyps were followed up for 3-30 months, and recurrence was considered in 2 of them. In conclusion, the detection rate of colorectal polyps in children aged 1≤ y<4 years is high, and hematochezia is the main clinical manifestation. Standardized endoscopic treatment and follow-up monitoring are very important for children with colorectal polyps.

Melanosis coli: A factor not associated with histological progression of colorectal polyps.

ObjectiveIn this study we aimed to investigate the association of melanosis coli (MC) and the colorectal polyp detection rate (PDR).MethodsIn all, 1104 MC patients and 62 181 non‐MC participants were enrolled. And 2208 controls were matched by participants' age and gender, and quality of bowel preparation using the propensity score matching (PSM) method. Additionally, 490 polyps in MC and 980 in controls matched by age and gender, and size and location of polyps were analyzed. The association of PDR and pathological features of polyps with MC were also analyzed.ResultsMC patients showed a higher PDR (44.3% vs 39.3%, P = 0.006) and detection rate of low‐grade adenoma (45.4% vs 36.7%, P = 0.002) but fewer large polyps (≥10 mm) (18.8% vs 26.9%, P = 0.001), fewer polyps in the left colon (33.5% vs 40.0%, P = 0.018), and a lower detection rate of advanced adenoma/adenocarcinoma (17.4% vs 24.3%, P = 0.003) than the matched controls. On multivariate logistic regression analysis, MC was independently associated with an increased PDR (odds ratio 1.184, 95% confidence interval 1.045–1.343, P = 0.008). Analysis targeting polyps showed that there were significant differences in age, gender, location, and pathology (P < 0.001) between polyps with and without MC. However, after adjusting for participants' age and gender, size and location of polyps, there was no difference between the two groups in pathology (P = 0.635).ConclusionMC is independently associated with increased colorectal PDR, but not with histological progression of polyps.

Artificial intelligence can increase the detection rate of colorectal polyps and adenomas: a systematic review and meta-analysis.

Colonoscopy is an important method to diagnose polyps, especially adenomatous polyps. However, the rate of missed diagnoses is relatively high. In this study, we aimed to determine whether artificial intelligence (AI) improves the polyp detection rate (PDR) and adenoma detection rate (ADR) with colonoscopy. We performed a systematic search in PubMed, Cochrane Library, Embase, and Web of Science databases; the search included entries in the databases up to and including 29 February 2020. Five articles that involved a total of 4311 patients fulfilled the selection criteria. The results of these studies showed that both PDR and ADR increased with the assistance of AI compared with those in control groups {pooled odds ratio (OR) = 1.91 [95% confidence interval (CI) 1.68-2.16] and 1.75 (95% CI 1.52-2.01), respectively}. Good bowel preparation reduced the impact of AI, but significant differences were still apparent in PDR and ADR [pooled OR = 1.69 (95% CI 1.32-2.16) and 1.36 (95% CI 1.04-1.78), respectively]. The characteristics of polyps and adenomas also influenced the results. The average number of polyps and adenomas detected varied significantly by location, and small polyps and adenomas were more likely to be missed. However, the effect of the morphology of polyps and AI-assisted detection needs further studies. In conclusion, AI increases the detection rates of polyps and adenomas in colonoscopy. Without AI assistance, detection rates can be improved with better bowel preparation and training for small polyp and adenoma detection.

Detection Rate of Colorectal Polyps in Symptomatic Candidates of Colonoscopy: When Should We Do a Total Colonoscopy?

BACKGROUND The incidence of colorectal cancer is increasing in the northeast of Iran. Colorectal polyps are among the proposed risk factors noted, especially in the elder population. This study was designed to study the diagnosed cases of intestinal polyps detected from 2011 to 2016 in the northeast of Iran. METHODS The population consisted of symptomatic candidates referred to the colonoscopy center in Gorgan city. Based on the available colonoscopy and pathology reports, 1706 cases were enrolled after the exclusion of cases without sufficient data. RESULTS Among 1709 (55.5% males and 44.5% females) cases, 1405 cases with 1912 polyps were detected. Among them, 345 (25%) aged less than 50 years. Tubular adenoma (N = 826, 43.2%) and hyperplastic polyps (N = 519, 27.1%) were the top two histological findings. Out of 1405 patients with polyps, 660 (39.6%) polyps were detected in proximal colon (15.6% in proximal and 24% in both proximal and distal). Malignancies were detected in 13.2% (0.8% malignant polyps and 12.4% malignant masses). CONCLUSION A considerable number of colorectal adenomas in proximal colon and in patients younger than 50 years old, suggesting to schedule colorectal cancer screening from at least 10 years younger and continuing colonoscopy up to the proximal area.

Effect of antifoaming agent on benign colorectal tumors in colonoscopy: A meta-analysis.

BACKGROUNDAlthough several trials have shown that the addition of antifoaming agents to polyethylene glycol (PEG) can improve bowel preparation, whether PEG plus antifoaming agents have a beneficial role in the detection of benign tumors during colonoscopy has yet to be confirmed. Our aim was to clarify whether adding simethicone to PEG solution could improve the detection of benign colorectal tumors.AIMTo clarify whether adding simethicone to PEG solution could improve the detection of benign colorectal tumors.METHODSThe PubMed, EMBASE, and Cochrane Library databases were searched for articles published prior to September 2019. The outcomes included the detection rates of colorectal adenomas and polyps.RESULTTwenty studies were eligible. Although there was no difference in the colorectal adenoma detection rate (ADR), a significant effect of simethicone for diminutive adenomas (< 10 mm) was revealed in the group taking simethicone. We also found that simethicone could significantly improve the ADR in the proximal colon but did not affect the colorectal polyp detection rate. Furthermore, the subgroup analyses revealed a beneficial effect of simethicone on the ADR among Asians (P = 0.005) and those with an ADR < 25% (P = 0.003). Moreover, it was a significant finding that the low dose simethicone was as effective as the high dose one with respect to the detection of benign colorectal tumors.CONCLUSIONIn summary, the addition of simethicone to PEG might improve the detection of diminutive adenomas in the right colon by colonoscopy in Asia. Low-dose simethicone was recommended for the detection of benign colorectal tumors. However, large clinical trials are necessary to validate our results and determine the ideal dose of simethicone.

Detection of colorectal polyps and adenomas in asymptomatic health examination population and analysis of relevant clinical factors

Objective To analysis the incidence and relevant clinical factors of colorectal polyps and adenomas in population of health examination. Methods Colonoscopy results and clinical data of 615 cases undergoing health examination from January 2018 to March 2019 were analyzed retrospectively in International Medical Center, Beijing Friendship Hospital, Capital Medical University.There were 436 males and 179 females, average age 47.38 years, aged 18-81 years. The clinical data contained sex, age, smoking history, drinking history, body mass index.Chi-square test and trend chi-square test were used to compare the differences of polyp detection rate and adenoma detection rate in different populations. Multivariate Logistic regression analysis were applied to explore the potential factors associated with the polyp detection rate and adenoma detection rate. Results Two hundred and forty cases(39.02%) with colorectal disease were checked out, include 206 cases(33.50%) with colorectal polyps and 138 cases(22.44%) with colorectal adenomas. In the detection rate of colorectal polyps, male were higher than female[36.70%(160/436) vs 25.70%(46/179), χ2=6.89, P 0.05]. Multivariate Logistic regression analysis showed that age increasing, body mass index increasing, smoking and alcohol consumption were risk factors for colorectal polyps and adenomas. Conclusions The detection rate of colorectal polyps and adenomas are related with sex, age, smoking, drinking and body mass index. Age increasing, body mass index increasing and smoking are the risk factors for colorectal polyps, age increasing and body mass index increasing are the risk factors for colorectal adenomas. Key words: Colonoscopes; Adenoma; Asymptomatic examination; Colorectal polyps

Randomized, back-to-back trial of a new generation NBI with a high-definition white light (HQ290) for detecting colorectal polyps

Background: The benefits of narrow band imaging (NBI) for improving the detection rate of colorectal polyps remain unclear. New generation NBI using the 290 system (290-NBI) provides an at least two-fold brighter image than that of the previous version. We aimed to compare polyp miss rates between 290-NBI colonoscopy and high-definition white light endoscopy (HDWL).Methods: In total, 117 patients were randomized to undergo either 290-NBI or HDWL from June 2015 to February 2017. In the HDWL group, we performed HDWL as an initial inspection, followed by a second inspection with NBI. In the 290-NBI group, NBI was performed as the initial inspection, followed by a second inspection with HDWL. We compared polyp and adenoma detection rates and polyp miss rates (PMR) between the two groups and analyzed the factors associated with the PMR.Results: In total, 127 polyps were detected in the 117 patients. No differences in adenoma or polyp detection rates were observed between the two groups. The PMR for 290-NBI was 20.6% and that for HDWL was 33.9% (p = .068). However, the non-adenomatous PMR for 290-NBI was significantly lower than that of HDWL (11.5% vs. 52.2%, p = .002). Furthermore, the miss rates of polyps on the left side of the colon, flat-type polyps, and non-adenomatous polyps were significantly lower in the 290-NBI than HDWL.Conclusions: New generation NBI may reduce PMR, especially of flat-type and non-adenomatous polyps and those on the left side of the colon. (UMIN000025505)

Analysis of clinicopathological characteristics and changing trend of 77 978 cases of colorectal polyps and colorectal cancer detected by colonoscopy in the past 27 years

Objective To explore the detection rate of colorectal polyps and colorectal cancer under colonoscopy, and their clinicopathological characteristics and changing trend. Methods From January 1, 1991 to December 31, 2017, at Guangzhou First People′s Hospital, the colorectal polyps and colorectal cancer diagnosed by colonoscopy were collected. The gender, age, location of colorectal polyps and colorectal cancer and pathological type were retrospectively analyzed. Chi-square test was performed for statistical analysis. Results Among 77 978 patients underwent routine colonoscope examination, male and female accounted for 50.18% (39 132/77 978) and 49.82% (38 846/77 978), respectively; and the age was (52.8±15.7) years. A total of 23 240 patients with colorectal polyps were detected, and the total detection rate was 29.80%. The detection rate of colorectal polyps of male patients was higher than that of female patients (35.11%, 13 741/39 132 vs. 24.45%, 9 499/38 846), and the difference was statistically significant (χ2=1 059.16, P 0.05); while moderately differentiated adenocarcinoma increased, however, the highly and poorly differentiated type decreased (χ2=249.27, P 0.05). Conclusions The detection rate of colorectal polyps increased in the past 27 years, while colorectal cancer decreased. The elderly men are susceptible populations. The most common location of colorectal polyps and cancer are left colon, which should be carefully examined during colonoscope examination. Key words: Colorectal neoplasms; Colonoscopy; Pathology; Colorectal polyps

Influencing factors on the detection rate of colorectal polyps in colonoscopy using repeated examination

Objective To study influencing factors on the detection rate of colorectal polyps by repeated examination in colonoscopy. Methods A total of 900 patients in the digestive endoscopy center of the People′s Hospital of Xinjiang Uygur Autonomous Region received colonoscopy, 300 patients were randomly selected for a second examination and they were selected for three times examination from August 2016 to March 2017. Objective factors for colonoscopy were strictly controlled during the examination, such as endoscopists′ experience, endoscopic operating method, cleansing degree of the intestine and withdrawal time. The characteristics of polyps were recorded, including number, location, shape, size and pathological types of polyps. The characteristics of polyps were compared between the same patient, and between the first-examination group, the second-examination group and the third-examination group. Logistic regression was used to analyze the independent influencing factors of missed diagnosis. Results A relatively high rate of missed diagnosis could occur in multiple polyps, ascending colon polyps, transverse colon polyps, sigmoid polyps, stepless polyps and small polyps ( 0.05). Logistic regression analysis showed that the number, location, shape and size of colorectal polyps were all independent factors influencing the detection rate(all P 0.05). Conclusion The number, location, shape and size of colorectal polyps are all independent factors influencing the detection rate. The detection rate of polyps may be improved by using the second colonoscopy. Key words: Intestinal polyps; Colonoscopy; Secondary colonoscopy

Comparison of clinicopathological features between gastric polyps and colorectal polyps

Objective To compare of clinical and pathological features between gastric polyps and colorectal polyps. Methods The clinical characteristics and pathological features of 2 125 patients with gastric polyps and 4 924 patients with colorectal polyps admitted in Wenzhou People's Hospital from 2004 to 2013 were compared. The detection rates, the indication of endoscopy, distribution, number, size and pathological type of gastric polyps and colorectal polyps were analyzed. Results The detection rate of gastric polyps was 3.1%(2 125/69 575)and that of colorectal polyps was 24.5%(4 924/20 124)(χ2=9 886.401, P<0.01). The detection rates of gastric polyps in age groups<20, 20-39, 40-59 and ≥60 were 1.8%(23/1 302), 1.8%(399/22 600), 3.4%(1 137/33 087)and 4.5%(566/12 586), respectively (χ2=238.867, P<0.01); and those for colorectal polyps were 6.6%(14/211), 11.6%(623/5 385), 26.0%(2 622/10 070)and 37.3%(1 665/4 458), respectively (χ2=934.724, P<0.01). The detection rates of gastric polyps in age groups 20-39, 40-59 and ≥60 were lower than those in colorectal polyps(all P<0.01). The detection rate of gastric polyps in males was lower than that in females(2.3%, 848/36 447 vs. 3.9%, 1 277/33 128, χ2=273.807, P<0.01), while the detection rate of colorectal polyps in males was higher than that in females (28.8%, 3 239/11 230 vs. 18.9%, 1 685/8 894, χ2=262.518, P<0.01). Diarrhea and gastrointestinal bleeding in patients with colorectal polyps was more common than those in patients with gastric polyps (23.5%, 1 156/4 924 vs. 2.5%, 54/2 125, χ2=558.080, P<0.01; 12.1%, 597/4 924 vs. 2.4%, 51/2 125, χ2=168.150, P<0.01). Single polyps were more common in gastric polyps than colorectal polyps(80.7%, 1 714/2 125 vs. 67.6%, 3 331/4 924, χ2=186.337, P<0.01). Polyps with size ≥1.0 cm were more common in colorectal polyps than those in gastric polyps (24.3%, 1 197/4 924 vs. 13.6%, 289/2 125, χ2=102.333, P<0.01). The proportion of inflammatory and hyperplastic types in gastric polyps was higher than that in colorectal polyps (67.1%, 1 378/2 125 vs. 27.5%, 1 273/4 924, χ2=934.394, P<0.01; 26.9%, 552/2 125 vs. 9.9%, 459/4 924, χ2=319.588, P<0.01); while the proportion of adenoma and canceration in gastric polyps was lower than that in colorectal polyps (1.7%, 34/2 125 vs. 62.4%, 2 893/4 924, χ2=2 135.743, P<0.01; 0.4%, 9/2 125 vs. 4.8%, 221/4 924, χ2=80.362, P<0.01). Conclusions In comparison with gastric polyps, the detection rate of colorectal polyps is higher. The detection rate of gastric polyps is higher in females, while that of colorectal polyps is higher in males. The detection rates of gastric polyps and colorectal polyps increase with the age. The main pathological type of gastric polyps is inflammatory, while that of colorectal polyps is adenoma.The canceration of colorectal polyps is more common than that of gastric polyps. Key words: Polyps; Stomach; Intestine, large; Disease attributes

Increased Detection of Colorectal Polyps in Screening Colonoscopy Using High Definition i-SCAN Compared with Standard White Light.

Background/Aims:The aim of this study was to evaluate the efficacy of high definition (HD) i-SCAN for colorectal polyp detection in screening colonoscopy. Methods:We retrospectively analyzed the records of 501 patients who had undergone screening colonoscopy performed by three endoscopists with either HD i-SCAN (n=149) or standard white light (n=352) from January 2, 2014 through June 30, 2014. Patient information and inter-endoscopist variation as well as polyp number, endoscopic findings, and pathologic characteristics were reviewed.Results:The detection rates of colorectal and neoplastic polyps were significantly higher using HD i-SCAN than standard white light colonoscopy (52% vs. 38.1%, p=0.004 for colorectal polyps; and 37.2% vs. 27.9%, p=0.041 for neoplastic polyps). Analysis of endoscopic findings revealed no difference in detected polyp size between HD i-SCAN and standard white light colonoscopy (4.59±2.35 mm vs. 4.82±2.81 mm, p=0.739), but non-protruding polyps were more commonly detected by i-SCAN than by standard white light colonoscopy (24.6% vs. 13.5%, p=0.007). Conclusions:Colonoscopy using HD i-SCAN had a significantly higher detection rate of colorectal polyps, including neoplastic polyps, because of improved sensitivity for detecting non-protruding lesions.

The value of I-SCAN technology for diagnosis of colorectal polyps

Objective To investigate the value of I-SCAN technology for diagnosis of colorectal polyps by comparing the difference of detection rate in polyp and adenoma between I-SCAN and normal high-definition endoscopy groups. Methods This study was a single-center, prospective, randomized case controlled study. The patients of two groups were allocated at random using the table of random numbers. The intubation procedures in experimental group were under normal high-definition mode while the withdrawal procedures were under I-SCAN mode. In the controlled group, all the procedures were under normal high-definition mode.The photographing and biopsy operation was done only in withdrawal procedures. All the lesions were diagnosed by pathology. The polyp detection rate and adenoma detection rate were evaluated. Results A total of 228 patients were included in the study, 115 patients in experimental group while 113 in controlled group. There was no significant difference in withdraw time [(7.3±3.6)min VS (6.4±4.3)min, P=0.07] and the colon cleanliness[(7.4±1.5) VS (7.4±2.3), P=0.942] between the experimental group and the controlled group. And there was no complication in either group. The detection rate of colorectal polyps of the experimental group was 57.39% (66/115), while that of controlled group was 33.62%(38/113), with significant statistical difference(P=0.001). The detection rate of colorectal adenoma of the experimental group was 35.65% (41/115), while that of the controlled group was 24.78% (28/113), with no significant difference(P=0.074). Conclusion The polyp detection rate of I-SCAN group is higher than normal high-definition endoscopy group. I-SCAN has broad prospects. Key words: Colorectal neoplasms; Colorectal polyps; Colorectal adenoma; I-SCAN; Detection rate

Analysis on colonoscopic results of screening 1 990 community people with high-risk of colorectal cancer

Objective To investigate the prevalence of colorectal cancer in community people in Shanghai, and clarify the necessity of colorectal cancer screening in community residents. Methods From April 2013 to September 2014, colonoscopy examination was carried out in people who participated in colorectal cancer screening in Shanghai with positive result of fecal occult blood test or with high-risk in colorectal cancer evaluated with the risk factors questionnaire. A total of 1 990 individuals were recruited. The colonoscopic results of them were retrospectively analyzed. Chi-square test was performed for statistical analysis. Results The 1 990 individuals received colonoscopy examination aged from 50 to 92. Among the 1 990 individuals with colonoscopy examination, colorectal polyps, colorectal cancer and carcinoid were found in 1 027 cases, and the total detection rate was 51.6%. The detection rate of colorectal polyps was 48.7% (969/1 990), and the maximum diameter of polyps was 3.5 cm. The detection rate of colorectal polyps of the male was 59.3% (532/897), which was higher than that of the female (40.0%, 437/1 093), and the difference was statistically significant (χ2=73.7, P<0.01). The detection rate of colorectal polyps in group 50 to 60 (not include 60) years old, 60 to 70 (not include 70) years old, 70 to 80 (not include 80) years old and ≥80 years old was 37.5% (139/371), 48.7% (524/1 075), 55.9% (248/444) and 58.0% (58/100), respectively. The difference was statistically significant (χ2=31.3, P<0.01). The detection rate of colorectal cancer was 2.7%(54/1 990). The detection rate of male rectal cancer was 3.8% (34/897), which was significantly higher than that of female (1.8%, 20/1 093), and the difference was statistically significant (χ2=7.2, P<0.05). The detection rate of colorectal cancer in group 50 to 60 (not include 60) years old, 60 to 70 (not include 70) years old, 70 to 80 (not include 80) years old and ≥80 years old was 1.6% (6/371), 1.9% (20/1 075), 4.3% (19/444) and 9.0% (9/100), respectively. The difference was statistically significant (χ2=23.7, P<0.01). The detection rate of rectal carcinoid was 0.2% (4/1 990). Conclusions The prevalence of colorectal polyps and cancer is high in screening community people with high-risk of colorectal cancer. Colorectal cancer screening in community people ≥50 years old with sequential screening method is important. Key words: Colorectal neoplasms; Colorectal polyps; Colonoscopy; Screening

The Effect of Indigocarmine on Improvement of the Polyp Detection Rate during Colonoscopic Examination with Hood Cap.

Background/AimsHood cap-assisted chromocolonoscopy using indigocarmine is expected to improve the detection rate of colorectal polyps, especially adenomatous polyps. Therefore, aim of the present study was to evaluate the usefulness of hood cap-assisted chromocolonoscopy in routine colonoscopic examinations.MethodsFrom January, 2013 through March, 2013, a total of 86 patients were enrolled (M:F=33:53, mean age=60 years). For each patient, hood cap-assisted colonoscopic examination was performed, followed by hood cap-assisted chromocolonoscopy using 0.2% indigocarmine from the cecum to the hepatic flexure. Total numbers and characteristics of polyps were compared before and after indigo carmine dye spraying.ResultsPrior to dye spraying, 48 polyps were found in 37 patients, and after dye spraying, 53 additional polyps were found in 34 patients. Of these undetected polyps, 45 (85%) were small sized polyps (≤0.5 cm). Histologically, 19 (36%) were adenomatous polyps, and of these, 15 (28%) were tubular adenomas and 4 (8%) were serrated adenomas. As for the polyp detection rate, there was no difference between the expert and the non-expert groups.ConclusionHood cap-assisted chromocolonoscopic examination using indigocarmine was helpful in detecting cecum and ascending colon polyps, especially small sized polyps (<0.5 cm) and neoplastic polyps.

Does metformin affect the incidence of colonic polyps and adenomas in patients with type 2 diabetes mellitus?

Background/AimsColorectal cancer (CRC) develops from colonic adenomas. Type 2 diabetes mellitus (DM) is associated with a higher risk of CRC and metformin decreases CRC risk. However, it is not certain if metformin affects the development of colorectal polyps and adenomas. This study aimed to elucidate if metforminaffects the incidence of colonic polyps and adenomas in patients with type 2 DM.MethodsOf 12,186 patients with type 2 DM, 3,775 underwent colonoscopy between May 2001 and March 2013. This study enrolled 3,105 of these patients, and divided them in two groups: 912 patients with metformin use and 2,193 patients without metformin use. Patient clinical characteristics, polyp and adenoma detection rate in the two groups were analyzed retrospectively.ResultsThe Colorectal polyp detection rate was lower in the metformin group than in the non-meformin group (39.4% vs. 62.4%, P<0.01). Colorectal adenoma detection rate was significantly lower in the metformin group than in the non-metformin group (15.2% vs. 20.5%, P<0.01). Fewer advanced adenomas were detected in the metformin group than in the non-metformin group (12.2% vs. 22%, P<0.01). Multivariate analysis identified age, sex, Body mass index and metformin use as factors associated with polyp incidence, whereas only metforminwas independently associated with decreased adenoma incidence (Odd ratio=0.738, 95% CI=0.554-0.983, P=0.03).ConclusionsIn patients with type 2 DM, metformin reduced the incidence of adenomas that may transform into CRC. Therefore, metformin may be useful for the prevention of CRC in patients with type 2 DM.

Withdrawal Times Affects Polyp and Diverticulum Detection on the Right-Side Colon

We aimed to investigate the association between colorectal polyp detection rates and withdrawal times, and also to investigate diverticulum detection rates as a counterpart lesion. Thirteen trainee colonoscopists were characterized by their mean withdrawal time for normal colon. A total of 2,314 colonoscopies were analyzed. The mean withdrawal times ranged from 6.5 to 10.4 minutes among colonoscopists. Polyp detection rates in individual endoscopists ranged between 36.5% and 60.0%. When stratified by the hood use, a significant association was shown when the hood was not used (p=0.03), whereas no association was found when the hood used. On the other hand, diverticulum detection rates varied from 20.7% to 43.2%. A strong association was shown only when the hood was not used (p=0.009). An association between the polyp or diverticulum detection rate and the withdrawal time was observed when the transparent hood was not attached, and mainly on the right-side colon.

Colorectal Polyp Detection Rates During Colonoscopy: A Retrospective Comparison of 19” CRT Monitor Versus 42” Plasma Monitor

Colorectal Polyp Detection Rates During Colonoscopy: A Retrospective Comparison of 19” CRT Monitor Versus 42” Plasma Monitor

Increase in Serrated Polyp Detection Rate Over Time in a Cohort of Average Risk Patients Undergoing Screening Colonoscopy

Purpose: Serrated polyps represent precursor lesions in an alternative pathway to colorectal cancer which may account for 15% of all colorectal cancers diagnosed in the United States. Premalignant serrated polyps are frequently flat or sessile, subtle, located in the proximal colon and may be overlooked during colonoscopy. Awareness of the association of such lesions with risk for carcinoma has become generally known only in recent years. The aim of this study was to determine if the detection rate of serrated polyps in an average risk screening population has increased over time. Methods: Endoscopy and pathology reports were reviewed from all patients undergoing average risk colorectal neoplasia screening colonoscopies at Boston Medical Center from 2006 through 2008. Polyps were classified as adenoma (including tubular adenoma, tubulovillous and villous adenoma), serrated polyp (including hyperplastic polyp, serrated adenoma and sessile serrated adenoma), normal mucosa, or other. Polyp detection was summarized with count statistics and reported as rate per 100 screening colonoscopies. Differences in polyp distribution were assessed with the χ2 test for trends in proportions with α set to 0.05 and two-sided P values. All analyses were performed with the R Language and Environment for Statistical Computing version 2.9.0. Results: Included in the study were specimens of 4805 polypoid lesions from 8739 average risk screening colonoscopies. The rate of polyp detection per 100 screening colonoscopies was 24.0 (95% CI 23.2 to 24.7) for adenomas and 16.4 (95% CI 15.7 to 17.0) for serrated polyps. The detection rate of proximal serrated polyps, proximal sessile serrated adenomas, and both proximal and distal adenomas increased from 2006 to 2008 (Table). The difference in serrated polyp detection rates by year appeared to be mainly attributable to increased detection of proximal sessile serrated adenomas.Table: Table. Rate of detected polyps per 100 colonoscopies by year and locationConclusion: This study describes the detection rate of colorectal polyps in average risk screening colonoscopies at an urban academic medical center over a recent 3 year period. Practice personnel and technology were constant over this time. There was a statistically significant increase in the detection rate of proximal serrated polyps and both proximal and distal adenomas over the period. Increased awareness of the clinical significance of flat and sessile lesions including proximal hyperplastic polyps and sessile serrated adenomas may account in part for these findings.

Colonoscopic Withdrawal Times and Detection Rates of Colorectal Polyps

Background: The polyp detection rates have recently been emphasized as a quality indicator of colonoscopy. The colonoscopic withdrawal time has been elucidated to be highly associated with polyp detectability. Objectives: To investigate the association between colorectal polyp detection rates and colonoscopic withdrawal times in the examinations by trainee colonoscopists for Japanese patients. Methods: Procedural data performed at The University of Tokyo Hospital were reviewed. Thirteen trainee colonoscopists were characterized by their mean withdrawal time for normal colon.

Computed Tomographic Colography and Virtual Colonoscopy

CT colography (CTC) is a powerful new approach to imaging the colorectum and a promising screening tool for the detection of colorectal neoplasia. From data generated by a helical CT scan, CTC uses virtual reality technology to produce highly discriminant two- and three-dimensional images that permit a thorough and minimally invasive evaluation of the entire colorectum. A dynamic CTC display technique from the endoluminal perspective, called cf2virtual colonoscopy,cf1 simulates colonoscopy by "flying" through the three-dimensional colon image. CTC offers potential advantages in diagnostic performance, safety, and patient acceptance over current screening approaches. Although early data suggest excellent colorectal polyp detection rates, this nascent technology will require rigorous clinical investigation and further refinements to assess adequately its place in the endoscopist's armamentarium.