title: Latest generation, wide-angle, high-definition colonoscopes increase adenoma detection rate.
abstract: OBJECTIVE
  Improvements to endoscopy imaging technologies might improve detection rates of colorectal cancer and patient outcomes. We compared the accuracy of the latest generation of endoscopes with older generation models in detection of colorectal adenomas.
  
  
  METHODS
  We compared data from 2 prospective screening colonoscopy studies (the Berlin Colonoscopy Project 6); each study lasted approximately 6 months and included the same 6 colonoscopists, who worked in private practice. Participants in group 1 (n = 1256) were all examined by using the latest generation of wide-angle, high-definition colonoscopes that were manufactured by the same company. Individuals in group 2 (n = 1400) were examined by endoscopists who used routine equipment (a mixture of endoscopes from different companies; none of those used to examine group 1). The adenoma detection rate was calculated on the basis of the number of all adenomas/number of all patients.
  
  
  RESULTS
  There were no differences in patient parameters or withdrawal time between groups (8.0 vs 8.2 minutes). The adenoma detection rate was significantly higher in group 1 (0.33) than in group 2 (0.27; P = .01); a greater number of patients with least 1 adenoma were identified in group 1 (22.1%) than in group 2 (18.2%; P = .01). A higher percentage of high-grade dysplastic adenomas were detected in group 1 (1.19%) than in group 2 (0.57%), but this difference was not statistically significant (P = .06).
  
  
  CONCLUSIONS
  The latest generation of wide-angle, high-definition colonoscopes improves rates of adenoma detection by 22%, compared with mixed, older technology endoscopes used in routine private practice. These findings might affect definitions of quality control parameters for colonoscopy screening for colorectal cancer.
authors: Central Interdisciplinary Endoscopy Unit, Department of Gastroenterology, Charité University Medical Hospitals, Berlin, Germany.
authors: Andreas
authors: A
authors: Adler
authors: Alireza
authors: A
authors: Aminalai
authors: Jens
authors: J
authors: Aschenbeck
authors: Rolf
authors: R
authors: Drossel
authors: Michael
authors: M
authors: Mayr
authors: Mathias
authors: M
authors: Scheel
authors: Andreas
authors: A
authors: Schröder
authors: Timur
authors: T
authors: Yenerim
authors: Bertram
authors: B
authors: Wiedenmann
authors: Ulrich
authors: U
authors: Gauger
authors: Stephanie
authors: S
authors: Roll
authors: Thomas
authors: T
authors: Rösch
mesh_terms: D000236:Adenoma / Q000175:diagnosis*; D000368:Aged; D001604:Berlin; D020685:Colonoscopes; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity