title: New-Generation High-Definition Colonoscopes Increase Adenoma Detection when Screening a Moderate-Risk Population for Colorectal Cancer.
abstract: Adenoma detection rate (ADR) is the most important quality indicator for screening colonoscopy, due to its association with colorectal cancer outcomes. As a result, a number of techniques and technologies have been proposed that have the potential to improve ADR. The aim of this study was to assess the potential impact of new-generation high-definition (HD) colonoscopy on ADR within the Bowel Cancer Screening Programme (BCSP).
  
  
  
  This was a retrospective single-center observational study in patients undergoing an index screening colonoscopy. The examination was performed with either standard-definition colonoscopes (Olympus Q240/Q260 series) or HD colonoscopes (Olympus HQ290 EVIS LUCERA ELITE system) with the primary outcome measures of ADR and mean adenoma per procedure (MAP) between the 2 groups.
  
  
  
  A total of 395 patients (60.5% male, mean age 66.8 years) underwent screening colonoscopy with 45% performed with HD colonoscopes. The cecal intubation rate was 97.5% on an intention-to-treat basis and ADR was 68.6%. ADR with standard-definition was 63.13%, compared with 75.71% with HD (P = .007). The MAP in the HD group was 2.1 (± 2.0), whereas in the standard-definition group it was 1.6 (± 1.8) (P = .01). There was no significant difference in withdrawal time between the 2 groups. In the multivariate regression model, only HD scopes (P = .03) and male sex (P = .04) independently influenced ADR.
  
  
  
  Olympus H290 LUCERA ELITE HD colonoscopes improved adenoma detection within the moderate-risk population. A 12% improvement in ADR might be expected to increase significantly the protection afforded by colonoscopy against subsequent colorectal cancer mortality.
authors.affiliation: Department of Gastroenterology and Hepatology, Royal Liverpool and Broadgreen University Hospital Trust, Liverpool, UK.
authors.forename: Ashley
authors.initials: A
authors.lastname: Bond
authors.affiliation: Department of Gastroenterology and Hepatology, Royal Liverpool and Broadgreen University Hospital Trust, Liverpool, UK; Liverpool and Wirral Bowel Screening Programme, Liverpool, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: O'Toole
authors.affiliation: Department of Gastroenterology and Hepatology, Royal Liverpool and Broadgreen University Hospital Trust, Liverpool, UK.
authors.forename: Gareth
authors.initials: G
authors.lastname: Fisher
authors.affiliation: Department of Gastroenterology and Hepatology, Royal Liverpool and Broadgreen University Hospital Trust, Liverpool, UK; Liverpool and Wirral Bowel Screening Programme, Liverpool, UK.
authors.forename: Sreedhar
authors.initials: S
authors.lastname: Subramanian
authors.affiliation: Department of Gastroenterology and Hepatology, Royal Liverpool and Broadgreen University Hospital Trust, Liverpool, UK; Liverpool and Wirral Bowel Screening Programme, Liverpool, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: Haslam
authors.affiliation: Department of Gastroenterology and Hepatology, Royal Liverpool and Broadgreen University Hospital Trust, Liverpool, UK; Department of Gastroenterology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Probert
authors.affiliation: Clinical Cancer Trials Unit, University of Liverpool, Liverpool, UK.
authors.forename: Trevor
authors.initials: T
authors.lastname: Cox
authors.affiliation: Department of Gastroenterology and Hepatology, Royal Liverpool and Broadgreen University Hospital Trust, Liverpool, UK; Clinical Cancer Trials Unit, University of Liverpool, Liverpool, UK. Electronic address: sanchoy@aol.com.
authors.forename: Sanchoy
authors.initials: S
authors.lastname: Sarkar
mesh_terms: D000236:Adenoma / Q000175:diagnosis*; D000368:Aged; D020685:Colonoscopes; D003113:Colonoscopy / Q000295:instrumentation*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk
keywords: Adenoma detection rate; Bowel cancer screening program; Colonoscopy; Colorectal cancer; High definition