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7 recent developments in colonoscopy
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In recent weeks, numerous developments in colonoscopy have been reported by gastroenterology professional societies and in the journals, including information on new regulatory issues, the latest efficacy data in cancer prevention and a meta-analysis of bowel preparation regimens.
Here are seven highlights of news stories focused on colonoscopy recently presented by Healio Gastroenterology.
1. ASGE, ACG, AGA oppose cuts to colonoscopy reimbursement rates proposed by CMS
The American Society for Gastrointestinal Endoscopy, the American College of Gastroenterology and the American Gastroenterological Association have issued a joint statement opposing significant cuts to reimbursement rates for colonoscopy and other lower GI endoscopic procedures proposed by the Centers for Medicare and Medicaid Services on July 8.
“Cuts of this magnitude could compromise the nation’s public health efforts to reduce colorectal cancer,” according to the release. Read more
2. Colorectal cancer more survivable when detected by screening vs. diagnostic colonoscopy
Kilian Friedrich
Patients with colorectal cancer diagnosed during screening colonoscopy survived longer than those whose cancer was confirmed during diagnostic colonoscopy, according to recent study data.
“Although CRC-screening methods differ between nations, our main finding of prolonged survival in cancers diagnosed at screening colonoscopy likely applies to screening colonoscopy in other countries,” Kilian Friedrich, MD, from the department of gastroenterology at University Hospital of Heidelberg in Germany, and colleagues wrote. Read more
3. Nurses safely perform screening colonoscopy, require longer procedure time
Endoscopy nurses who underwent a training program were able to safely and adequately perform screening colonoscopy, though they required a longer procedure time to achieve adenoma detection rates comparable to medical endoscopists.
“Adequate supervision, we believe, can be provided by medical endoscopists performing colonoscopy in a parallel room design as over 90% of colonoscopies performed by nurses in our study did not require any direct assistance,” the researchers wrote. Read more
4. Higher quality screening colonoscopies reduce colorectal cancer incidence, death without higher costs
Reinier G. S. Meester
Higher adenoma detection rates in screening colonoscopy were found to be associated with as high as 50% to 60% lower lifetime risk for colorectal cancer incidence and death without incurring higher overall costs.
“Our results confirm the belief that [adenoma detection rates] are likely an important colonoscopy quality measure,” Reinier G. S. Meester, MSc, from Erasmus MC University Medical Center in the Netherlands, told Healio Gastroenterology. Read more
5. Split-dose superior to day-before bowel prep for colonoscopy
Split-dose bowel cleansing regimens were found to be superior to day-before preparations in terms of colon cleansing quality and patient preference in a recent meta-analysis.
“Split-dose regimens yield the highest quality of colon cleansing across all types of colonic preparations,” the researchers concluded. Read more
6. Younger first-degree relatives of colorectal cancer patients less likely to have colonoscopy
Sudha Xirasagar 
While colonoscopy screening rates have increased 5-fold in the past 10 years, first-degree relatives of colorectal cancer patients aged younger than 50 years are less likely to have a colonoscopy than adults aged 50 or older.
“Our study shows the need for increasing screening rates in this subgroup, particularly first-degree relatives younger than 50 because of the recent increase in [colorectal cancer] among American adults in this age group,” Sudha Xirasagar, PhD, MBBS, and colleagues wrote. Read more
7. Surveillance colonoscopy may reduce CRC risk, need for colectomy in UC
A 40-year analysis of a colonoscopic surveillance program for neoplasia in ulcerative colitis suggested surveillance colonoscopy may play an important role in reducing colorectal cancer risk and need for colectomy.
“The advent of chromoendoscopy in recent years has increased the rate of dysplasia detection. This has not led to the reduction in overall CRC risk, but has allowed the early identification of high-risk patients and played an important role in reducing the risk of advanced and interval cancer,” the researchers wrote. Read more