title: Screening colonoscopy: should we focus more on technique and less on technology?
abstract: Several large studies have confirmed that high quality colonoscopic surveillance can improve outcomes with substantial reduction in colorectal cancer rates. In order to improve outcomes from screening colonoscopy and help detect adenomas, the emphasis has been mainly on improvements in technology like high-resolution scopes, computerized as well as dye-based chromoendoscopy and wide-angle endoscopes. In addition to the equipment and technological innovation in the equipment used, a number of other factors like experience of the endoscopist, optimal withdrawal techniques, position changes during colonoscopy and bowel preparation can all influence adenoma detection and thereby the quality of colonoscopic surveillance. In this review we will focus on recent studies investigating these aspects of colonoscopy and their impact on adenoma or polyp detection.
authors: Department of Gastroenterology, Leeds Teaching Hospital NHS Trust Leeds LS9 7TF.
authors: Noor
authors: N
authors: Mohammed
authors: Venkataraman
authors: V
authors: Subramanian
references: Am J Gastroenterol. 2010 Dec;105(12):2588-96
references: 20877348
references: Clin Gastroenterol Hepatol. 2012 Nov;10(11):1225-31
references: 22940741
references: Endoscopy. 2012 Nov;44(11):1019-23
references: 22930173
references: Clin Gastroenterol Hepatol. 2009 Dec;7(12):1335-40
references: 19665583
references: Br J Surg. 2012 Oct;99(10):1436-44
references: 22961527
references: Am J Gastroenterol. 2013 Feb;108(2):219-26; quiz 227
references: 23295274
references: Gastrointest Endosc. 2011 Mar;73(3):456-63
references: 20950801
references: Aliment Pharmacol Ther. 2012 Jan;35(2):222-37
references: 22112043
references: Cancer. 2012 Jun 15;118(12):3044-52
references: 21989586
references: World J Gastroenterol. 2008 Nov 14;14(42):6503-5
references: 19030202
references: Gastrointest Endosc. 2012 Aug;76(2):381-7
references: 22817789
references: Gastrointest Endosc. 2012 Jan;75(1):127-33
references: 21963062
references: Gastrointest Endosc. 2010 Oct;72(4):686-92
references: 20883845
references: Am J Gastroenterol. 2003 Jul;98(7):1504-7
references: 12873570
references: Am J Gastroenterol. 2008 Jun;103(6):1541-9
references: 18479499
references: Gastrointest Endosc. 2011 Jun;73(6):1223-31
references: 21481861
references: Surg Endosc. 2012 May;26(5):1337-42
references: 22083333
references: Dis Colon Rectum. 2009 Jul;52(7):1337-44
references: 19571713
references: Gastrointest Endosc. 2011 Jul;74(1):128-34
references: 21531410
references: Gastrointest Endosc. 2012 Apr;75(4):827-34
references: 22321696
references: Gastrointest Endosc. 2012 Mar;75(3):583-90
references: 22177570
references: J Clin Gastroenterol. 2010 Apr;44(4):e80-6
references: 19881361
references: J Clin Gastroenterol. 2011 Mar;45(3):253-8
references: 21085007
references: J Natl Cancer Inst. 2010 Jan 20;102(2):89-95
references: 20042716
references: Am J Gastroenterol. 2010 Nov;105(11):2312-7
references: 21048675
references: Gastrointest Endosc. 2012 Mar;75(3):537-44
references: 22192423
references: Endoscopy. 2012 Oct;44(10):917-22
references: 22893135
references: Gastrointest Endosc. 2012 Sep;76(3):603-8.e1
references: 22732876
references: Gastrointest Endosc. 2012 Apr;75(4):835-40
references: 22317882
references: Gastroenterology. 2011 Jan;140(1):65-72
references: 20854818
references: Am J Gastroenterol. 2004 Mar;99(3):519-22
references: 15056095
references: N Engl J Med. 2012 Feb 23;366(8):687-96
references: 22356322
references: Am J Gastroenterol. 2011 Aug;106(8):1466-71
references: 21502998
references: Am J Gastroenterol. 2011 Aug;106(8):1457-65
references: 21448145
references: N Engl J Med. 1993 Dec 30;329(27):1977-81
references: 8247072
references: Gut. 2013 Feb;62(2):236-41
references: 22442161
references: J Cancer Educ. 2012 Jun;27(3):526-32
references: 22528638
references: Ann Intern Med. 2009 Jan 6;150(1):1-8
references: 19075198
references: N Engl J Med. 2010 May 13;362(19):1795-803
references: 20463339
references: Gastrointest Endosc. 2007 Feb;65(2):263-9
references: 17141772