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. 2021 Apr 26;21(1):467.
doi: 10.1186/s12885-021-08190-z.

Medical needs related to the endoscopic technology and colonoscopy for colorectal cancer diagnosis

Juan Francisco Ortega-Morán  1 , Águeda Azpeitia  2 , Luisa F Sánchez-Peralta  3 , Luis Bote-Curiel  3 , Blas Pagador  3 , Virginia Cabezón  2 , Cristina L Saratxaga  4 , Francisco M Sánchez-Margallo  3
Affiliations

Medical needs related to the endoscopic technology and colonoscopy for colorectal cancer diagnosis

Juan Francisco Ortega-Morán et al. BMC Cancer. .

Abstract

Background: The high incidence and mortality rate of colorectal cancer require new technologies to improve its early diagnosis. This study aims at extracting the medical needs related to the endoscopic technology and the colonoscopy procedure currently used for colorectal cancer diagnosis, essential for designing these demanded technologies.

Methods: Semi-structured interviews and an online survey were used.

Results: Six endoscopists were interviewed and 103 were surveyed, obtaining the demanded needs that can be divided into: a) clinical needs, for better polyp detection and classification (especially flat polyps), location, size, margins and penetration depth; b) computer-aided diagnosis (CAD) system needs, for additional visual information supporting polyp characterization and diagnosis; and c) operational/physical needs, related to limitations of image quality, colon lighting, flexibility of the endoscope tip, and even poor bowel preparation.

Conclusions: This study shows some undertaken initiatives to meet the detected medical needs and challenges to be solved. The great potential of advanced optical technologies suggests their use for a better polyp detection and classification since they provide additional functional and structural information than the currently used image enhancement technologies. The inspection of remaining tissue of diminutive polyps (< 5 mm) should be addressed to reduce recurrence rates. Few progresses have been made in estimating the infiltration depth. Detection and classification methods should be combined into one CAD system, providing visual aids over polyps for detection and displaying a Kudo-based diagnosis suggestion to assist the endoscopist on real-time decision making. Estimated size and location of polyps should also be provided. Endoscopes with 360° vision are still a challenge not met by the mechanical and optical systems developed to improve the colon inspection. Patients and healthcare providers should be trained to improve the patient's bowel preparation.

Keywords: CAD software; Classification; Colorectal cancer; Detection; Endoscopy; Medical needs.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

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Fig. 1
Current gold standard procedure
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References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021. 10.3322/caac.21660. - PubMed
    1. Stewart SL, Wike JM, Kato I, Lewis DR, Michaud F. A population-based study of colorectal cancer histology in the United States, 1998–2001. Cancer. 2006;107(S5):1128–1141. doi: 10.1002/cncr.22010. - DOI - PubMed
    1. Atkin WS, Edwards R, Kralj-Hans I, Wooldrage K, Hart AR, Northover JMA, Parkin DM, Wardle J, Duffy SW, Cuzick J. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet. 2010;375(Suppl 9726):1624–1633. doi: 10.1016/S0140-6736(10)60551-X. - DOI - PubMed
    1. Atia MA, Patel NC, Ratuapli SK, Boroff ES, Crowell MD, Gurudu SR, Faigel DO, Leighton JA, Ramirez FC. Nonneoplastic polypectomy during screening colonoscopy: the impact on polyp detection rate, adenoma detection rate, and overall cost. Gastrointest Endosc. 2015;82(Suppl 2):370–375. doi: 10.1016/j.gie.2015.01.016. - DOI - PubMed
    1. Rajasekhar PT, Mason J, Wilson A, Close H, Rutter M, Saunders B, East J, Maier R, Moorghen M, Rees C. OC-024 detect inspect characterise resect and discard 2: are we ready to dispense with histology? Gut. 2015;64(Suppl 1):A13.1–A1A13. doi: 10.1136/gutjnl-2015-309861.24. - DOI - PMC - PubMed