A prospective randomised study on narrow-band imaging versus conventional colonoscopy for adenoma detection: does narrow-band imaging induce a learning effect?

Adler, A.; Pohl, H.; Papanikolaou, I. S.; Abou-Rebyeh, H.; Schachschal, G.; Veltzke- Schlieker, W.; Khalifa, A. C.; Setka, E.; Koch, M.; Wiedenmann, B.; Rösch, T.
January 2008
Gut;Jan2008, Vol. 57 Issue 1, p59
Academic Journal
Background and aims: Colonoscopy is an established method of colorectal cancer screening, but has an adenoma miss rate of 10-20%. Detection rates are expected to improve with optimised visualisation methods. This prospective randomised study evaluated narrow-band imaging (NBI), a new technique that may enhance image contrast in colon adenoma detection. Methods: Eligible patients presenting for diagnostic colonoscopy were randomly assigned to undergo wide-angle colonoscopy using either conventional high-resolution imaging or NBI during instrument withdrawal. The primary outcome parameter was the difference in the adenoma detection rate between the two techniques. Results: A total of 401 patients were included (mean age 59.4 years, 52.6% men). Adenomas were detected more frequently in the NBI group (23%) than in the control group (17%) with a number of 17 colonoscopies needed to find one additional adenoma patient; however, the difference was not statistically significant (p = 0.129). When the two techniques were compared in consecutive subgroups of 100 study patients, adenoma rates in the NBI group remained fairly stable, whereas these rates steadily increased in the control group (8%, 15%, 17%, and 26.5%, respectively). Significant differences in the first 100 cases (26.5% versus 8%; p = 0.02) could not be maintained in the last 100 cases (25.5% versus 26.5%, p = 0.91). Conclusions: The increased adenoma detection rate means of NBI colonoscopy were statistically not significant. It remains speculative as to whether the increasing adenoma rate in the conventional group may have been caused by a training effect of better polyp recognition on NBI.


Related Articles

  • Yield of colonoscopy after recent CT-proven uncomplicated acute diverticulitis: a comparative cohort study. Daniels, Lidewine; Ünlü, Çağdaş; Wijkerslooth, Thomas; Stockmann, Hein; Kuipers, Ernst; Boermeester, Marja; Dekker, Evelien // Surgical Endoscopy;Sep2015, Vol. 29 Issue 9, p2605 

    Background: Current guidelines recommend routine follow-up colonoscopy after acute diverticulitis to confirm the diagnosis and exclude malignancy. Its value, however, has recently been questioned because of contradictory study results. Our objective was to compare the colonoscopic detection rate...

  • Fellow Involvement May Increase Adenoma Detection Rates During Colonoscopy. Rogart, Jason N.; Siddiqui, Uzma D.; Jamidar, Priya A.; Aslanian, Harry R. // American Journal of Gastroenterology;Nov2008, Vol. 103 Issue 11, p2841 

    BACKGROUND: Adenoma detection rate (ADR) is increasingly used as a quality indicator for screening/surveillance colonoscopy. Recent investigations to identify factors that affect ADR have focused on the technical aspects of the procedure or the equipment. OBJECTIVE: To assess whether...

  • Three points and a fixed penalty for speeding colonoscopists.  // Gut;Mar2007, Vol. 56 Issue 3, p416 

    The article focuses on the issues examined in the study concerning colonoscopy practice in Great Britain by endoscopists. New endoscopic technologies like magnification imaging, chromoscopy, narrow band imaging and confocal endomicroscopy have been developed to help both detection and in vivo...

  • Five-year risk of colorectal neoplasia after negative screening colonoscopy.  // British Journal of Hospital Medicine (17508460);Oct2008, Vol. 69 Issue 10, p600 

    The article presents the findings of the study involving persons identified without adenomas on baseline screening colonoscopy who returned at five years for follow-up colonoscopy. It is said that the appropriate interval for endoscopic rescreening following a negative colonoscopic examination...

  • The Prevalence Rate and Anatomic Location of Colorectal Adenoma and Cancer Detected by Colonoscopy in Average-Risk Individuals Aged 40–80 Years. Strul, Hana; Kariv, Revital; Leshno, Moshe; Halak, Aharon; Jakubowicz, Markus; Santo, Moshe; Umansky, Mark; Shirin, Haim; Degani, Ya’ara; Revivo, Miri; Halpern, Zamir; Arber, Nadir // American Journal of Gastroenterology;Feb2006, Vol. 101 Issue 2, p255 

    BACKGROUND: The role of screening colonoscopy for colorectal (CR) neoplasia in average-risk population, remains to be determined. OBJECTIVES: To evaluate the prevalence and anatomic location of CR adenoma and carcinoma and the morbidity of colonoscopy in individuals at average risk for CR cancer...

  • Colonoscopy: A Review of Its Yield for Cancers and Adenomas by Indication. Rex, Douglas K. // American Journal of Gastroenterology;Mar1995, Vol. 90 Issue 3, p353 

    Colonoscopy for bleeding indications (positive fecal occult blood test, emergent or nonemergent rectal bleeding, melena with a negative upper endoscopy and iron deficiency anemia) has a substantial yield for cancers (1 per 9 to 13 colonoscopies), although slide rehydration of fecal occult blood...

  • Colonic Adenoma Risk in Familial Colorectal Cancer–A Study of Six Extended Kindreds. Neklason, Deborah W.; Thorpe, Brett L.; Ferrandez, Angel; Tumbapura, Anil; Boucher, Kenneth; Garibotti, Gilda; Kerber, Richard A.; Solomon, Cindy H.; Samowitz, Wade S.; Fang, John C.; Mineau, Geraldine P.; Leppert, Mark F.; Burt, Randall W.; Kuwada, Scott K. // American Journal of Gastroenterology;Oct2008, Vol. 103 Issue 10, p2577 

    OBJECTIVES: Most colorectal cancers (CRCs) arise from adenomatous polyps, but the effects of CRC family history on adenoma risk are not well known. This issue is clinically relevant since several medical societies currently recommend earlier and more rigorous colorectal screening for individuals...

  • Detailed colonoscopy for detecting early superficial carcinoma: recent developments. TANAKA, SHINJI; HARUMA, KEN; ITO, MASAHIRO; NAGATA, SHINJI; OH-E, HIROTOKI; HIROTA, YUICHI; KUNIHIRO, MASAKI; KITADAI, YASUHIKO; YOSIHARA, MASAHARU; SUMII, KOJI; KAJIYAMA, GORO // Journal of Gastroenterology;2000 Supplement 12, Vol. 35, p121 

    Early superficial colorectal carcinoma (CRC) has been commonly detected by routine colonoscopic examination in Japan. A series of 769 early CRCs and 4821 adenomas were diagnosed by colonoscopy at Hiroshima University Medical Hospital between 1991 and 1998. Of early CRCs, macroscopically...

  • Invited comment on Morgan et al.: Transparent cap colonoscopy versus standard colonoscopy: a systematic review and meta-analysis. Trecca, A. // Techniques in Coloproctology;Aug2013, Vol. 17 Issue 4, p361 

    The author discusses the comparison between transparent cap colonoscopy and standard colonoscopy. He is critical of the colorectal cancer miss rate, which is the weak point of colonoscopy particularly as regards cancer screening and the adenoma detection rate. He mentions that 17 cap-assisted...


Read the Article


Sign out of this library

Other Topics