Endocuff improves polyp detection, ADR in colorectal cancer screening
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Key takeaways:
- Polyp detection rate in the Endocuff-assisted group was 72% vs. 57.4% in the standard colonoscopy group.
- Endocuff-assisted colonoscopy also increased estimated adenoma detection rate (51.8% vs. 41.3%).
VANCOUVER, British Columbia — Mechanical-enhanced colonoscopy outperformed standard colonoscopy in polyp detection rate and estimated adenoma detection rate for colorectal cancer screening, according to a presenter here.
“There is a range in the literature of adenoma miss rate and polyp miss rate, and those ranges go anywhere from 12% to 24%,” Seth A. Gross, MD, clinical chief of gastroenterology and hepatology and professor of medicine at NYU Grossman School of Medicine, said at the ACG Annual Scientific Meeting. “Endoscopists spend a lot of time trying to minimize polyp miss rate. We do split dose bowel prep, 6 minute or greater withdrawal time — really focus on improving inspection technique.
“When all of those approaches still don’t get us to where we want to be, there’s technology to help us improve our performance.”
To evaluate the effectiveness of Endocuff-assisted colonoscopy (EAC) on polyp detection rate (PDR) and estimated adenoma detection rate (eADR), Gross and colleagues conducted a retrospective cohort study of patients aged 50 years and older who underwent CRC screening.
Using the Premier Healthcare Database, they identified 893,560 screening colonoscopies performed between 2018 and 2021, of which 0.7% were performed using EAC and 99.3% were standard. PDR was calculated as the proportion of patients who had at least one polyp and eADR by multiplying PDR by 0.72.
Results demonstrated an overall PDR of 72% (95% CI, 70.8-73.1) vs. 57.4% (95% CI, 57.3-57.5) and an eADR of 51.8% (95% CI, 51-52.6) vs. 41.3% (95% CI, 41.2-41.4) among patients who underwent EAC vs. standard colonoscopy, respectively. Gross noted EAC bested standard colonoscopy regardless of age, gender, race and number of colonoscopies performed per physician during the study period.
“Our preliminary data show that Endocuff improves PDR and eADR for colonoscopy for colorectal cancer screening,” Gross concluded. “The likely reason is the mechanical principles of using a mechanical cap with finger projections allows for maximum exposure in a segment of the colon upon withdrawal.”
Gross continued: “The overall uptake of Endocuff in daily clinical practice is low, probably limited financial barriers for the cost of the single-use product.”
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Gross SA, et al. Use of mechanical enhanced colonoscopy to improve polyp detection during colorectal cancer screening: Preliminary results of real-world health care database analysis. Presented at: ACG Annual Scientific Meeting; Oct. 20-25, 2023; Vancouver, British Columbia (hybrid meeting).
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