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Colored Hi-Def Colonoscopy Doesn't Increase Adenoma Detection, reported at the American College of Gastroenterology meeting.

Adding colored dye to high-definition (HD) colonoscopy doesn't help doctors detect more adenomas than they do with regular HD colonoscopy, researchers said.

The technique did modestly increase detection of flat and small adenomas, but not by enough to matter in practice, Charles Kahi, MD, of Indiana University, and colleagues reported at the American College of Gastroenterology meeting here.

"Our findings don't support routine performance of chromocolonoscopy in average-risk patients," Kahi said.

The researchers said that nonpolypoid colon neoplasms -- those that are flat or depressed -- are an increasingly recognized precursor to colorectal cancer in Western populations.

High-definition chromoscopy is used to increase the yield of colonoscopy for these lesions because they are "more difficult to visualize in standard colonoscopy," Kahi said.

However, the technology's role in average-risk patients undergoing routine screening was uncertain, the researchers noted. So they randomized 660 patients from four U.S. medical centers to high-definition chromocolonoscopy or high-definition, white-light colonoscopy.

They included only patients who were having their first colonoscopy. Patients were excluded if they had undergone a previous colonoscopy or had other risk factors, including family history of adenoma.

The researchers found no significant difference between the two groups in number of patients with at least one adenoma (55.5% versus 48.4%), Kahi said.

Nor was there a significant difference between the number of adenomas per patient (1.3 versus 1.1) or the number of advanced adenomas under 10 mm (0.02 versus 0.01).

Chromocolonoscopy did, however, detect significantly more flat adenomas per patient (0.6 versus 1.2, P=0.01) and more adenomas under 5 mm in diameter (0.8 versus 1.3, P=0.03).

"The take-home message here is that there is a marginal increase in adenoma detection for chromocolonoscopy," Kahi said. "However, the magnitude of the effect was small and didn't meet statistical significance."

They noted that the high adenoma detection rates observed in the study may be due to the blanket use of high-definition technology in both groups.

Further research should include a direct comparison of the adenoma detection rates of high-definition colonoscopy with standard definition, they said.

Walter Coyle, MD, of Scripps Clinic in La Jolla, Calif., said high-definition chromocolonoscopy won't be employed for all patients -- more likely for those who are especially high risk.

Source: ACG

You can discuss more about Gastroenterology & Endoscopy and related topics in our Gastroenterology & Endoscopy group.