Original article—alimentary tract
High-Definition Colonoscopy Detects Colorectal Polyps at a Higher Rate Than Standard White-Light Colonoscopy

https://doi.org/10.1016/j.cgh.2009.11.009Get rights and content

Background & Aims

Adenoma detection rates might be improved through use of high-definition colonoscopy, which can detect subtle mucosal changes. We investigated whether the use of high-definition white-light (HDWL) colonoscopy resulted in a higher rate of adenoma detection than standard-definition white-light (SDWL) colonoscopy in a clinical practice setting.

Methods

This retrospective study included 2430 patients who underwent colonoscopies from September 2006 to December 2007; 1226 received SDWL colonoscopy and 1204 received HDWL colonoscopy. We analyzed data from consecutive screening, surveillance, and diagnostic colonoscopies, comparing adenoma and overall polyp detection between procedures. Potentially confounding variables were controlled using multivariable logistic regression analysis.

Results

The adenoma detection rate was higher among patients who underwent HDWL compared with SDWL colonoscopies (28.8% vs 24.3%; P = .012), as was the polyp detection rate (42.2% vs 37.8%; P = .026). These findings remained after adjustments for potentially confounding variables (P = .018 and .022, respectively).

Conclusions

In a general clinical practice setting, HDWL colonoscopy resulted in a higher adenoma detection rate compared with SDWL colonoscopy. The use of SDWL colonoscopy could reduce the number of missed adenomas and the subsequent risk for colorectal cancer.

Section snippets

Data Collection

The computerized clinical and endoscopic charts database of the Mayo Clinic Jacksonville served as a data source for this study, which was approved by the Mayo Clinic Institutional Review Board. We reviewed the computerized charts of patients who underwent colonoscopies between September 2006 and December 2007 in the outpatient general practice setting. Patient information was collected regarding age, sex, race, family history of colon cancer, history of polyps, and aspirin use. Colonoscopy

Results

Table 1 provides a summary of patient, colonoscopy, and endoscopist characteristics for both the 1204 HDWL and 1226 SDWL colonoscopy patients. Similar patient characteristics for the HDWL and SDWL groups included age, sex, race, family history of colon cancer, history of polyps, bowel preparation, endoscopist training, and the presence of a fellow. Aspirin use was slightly more common in patients in the HDWL group. The indication for procedure was more often “screening” in the HDWL group, and

Discussion

Our study showed that the use of high-definition colonoscopes was associated with a higher adenoma detection rate in comparison with standard-definition colonoscopes. This higher rate was most apparent for smaller adenomas (<10 mm) and adenomas in the left colon.

Although detection rates of smaller adenomas were more significant for diminutive (1–5 mm) adenomas known to be of the least risk of advanced of histology (3.9% difference) as compared with adenomas of 6 to 9 mm (2.5% difference), these

Acknowledgments

The authors wish to thank Ms Nancy Diehl for statistical assistance, Ms Katherine Purcell for manuscript editorial assistance, and all the fellows and staff of the Gastroenterology and Hepatology Division of the Mayo Clinic Jacksonville for contribution of data to this study.

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    Conflicts of interest The authors disclose the following: Dr Wallace receives research funding from Olympus and Fujinon, but does not receive any funds from the company that produces the products evaluated in this study. The remaining authors disclose no conflicts. Mayo Clinic does not endorse the products mentioned in this article.

    Funding The statistical analysis was funded by support for Fellowship Research provided by Fujinon, Inc, and TAP/Takeda Pharmaceuticals, Inc.

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