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Review
. 2019 Aug;35(4):215-225.
doi: 10.1159/000501835. Epub 2019 Jul 9.

Optimizing Screening Colonoscopy: Strategies and Alternatives

Hans-Dieter Allescher  1 , Vincens Weingart  1
Affiliations
Review

Optimizing Screening Colonoscopy: Strategies and Alternatives

Hans-Dieter Allescher et al. Visc Med. 2019 Aug.

Abstract

Screening colonoscopy is the most effective screening procedure for the prevention of colorectal cancer. The efficacy of colonoscopy is highly dependent on the overall quality of how this procedure is indicated, planned, prepared, and performed. The quality is directly linked to the number of polyps and/or adenomas detected or, in other words, to the number of polyps or adenomas missed during the procedure. The quality has a direct impact on the rate of interval carcinoma and on the range of how the incidence and occurrence of colorectal cancer is reduced. This review summarizes the current status on general measures and procedure improvements and standards as well as technical advances which have been suggested and established to improve the quality of polyp and adenoma detection rate. This includes selection and preparation of the patients, planning, methodological and technical performance of the procedure, and technical advances of the endoscope technology in order to improve screening results. It also covers new technologies with wide angle endoscopes (Ewave) and IT-based approaches using artificial intelligence to such as ai4GI for the polyp detection and image analysis.

Keywords: Adenoma detection rate; Colorectal cancer; Interval carcinoma; Polyp detection rate; Screening.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Design of the endoscopic suite with two monitors to assist the endoscopy nurse personnel acting as second observer during colonoscopy.
Fig. 2
Fig. 2
Endoscopic image of colonoscopic appearance of the mucosal fold using an EndoCuff device. The green flaps retract and stretch the mucosal folds.
Fig. 3
Fig. 3
Tip of an endoscope with Endorings® (Endopic EndoAid Ltd., Caesarea, Israel) attached.
Fig. 4
Fig. 4
Appearance of the G-Eye endoscope, which incorporated a rubber balloon incorporated to the distal end of the colonoscope.
Fig. 5
Fig. 5
a Endoscopic image of a serrated adenoma of the ascending colon with the typical white light appearance. The endoscopic image shows a slightly elevated flat lesion with a typical yellowish color and a mucous cap on top. b Endoscopic image of this typical serrated adenoma using NBI-II showing a typical reddening of the adenoma as an atypical vascular pattern.
Fig. 6
Fig. 6
Endoscopic tip of the full-spectrum endoscope with the LED light sources and the individual video chips in the prograde and side viewing direction.
Fig. 7
Fig. 7
a Tip of the EWAVE endoscope with the prograde view and the two backward oriented lenses. b, c Image examples of the EWAVE endoscope with the central forward view aspect and the outer side and backward viewing image.
See this image and copyright information in PMC

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