Second Proximal Colon Examination Produced Significant Rise in Adenoma Detection Rates
Douglas K. Rex, MD, MASGE, reviewing Yang QY, et al. Clin Transl Gastroenterol 2022 Dec 15.
Many experts now routinely examine the proximal colon twice because colonoscopy is less protective against colorectal cancer in the proximal colon than in the distal colon.
In this randomized controlled trial, 840 patients first underwent a forward-view examination from the appendiceal orifice to the splenic flexure. They were then randomized to undergo a repeat proximal colon examination (a colonic examination proximal to the splenic flexure) or no second proximal colon examination.
The proximal adenoma detection rates (ADRs) were 25.2% with 1 examination and 35.7% with 2 examinations. Whole-colon ADR with 2 proximal colon examinations was also higher at 44% versus 34% in those who received only 1 proximal colon examination.
COMMENTThis prospective randomized trial demonstrates a significant improvement in proximal and whole-colon ADRs when second proximal examinations are performed.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Yang QY, Zhu XJ, Wu ZX, Leng F, Shu X, Yang L. Impact of the second examination of the proximal colon on adenoma detection rate: a prospective randomized controlled trial. Clin Transl Gastroenterol 2022 Dec 15. (Epub ahead of print) (https://doi.org/10.14309/ctg.0000000000000557)
