Background and Aims
Randomized studies have demonstrated that a distal attachment cap with rubber side
arms, the Endocuff Vision (ECV; Olympus America, Center Valley, Pa, USA), increased
colonoscopic adenoma detection rate (ADR) in various mixed patient collectives. This
is the first study to evaluate its use in a primary colonoscopic screening program.
Methods
Patients over age 55 years undergoing screening colonoscopy in 9 German private offices
in Berlin and Hamburg were randomized to either the study group using ECV or the control
group using high-definition colonoscopies (standard of care). The main outcome parameter
was ADR, whereas secondary outcomes were detection rates of all adenomas per colonoscopy
(APCs), of adenoma subgroups, and of hyperplastic polyps.
Results
Of 1416 patients (mean age, 61.1 years; 51.8% women), with a median of 41 examinations
per examiner (n = 23; interquartile range, 12-81), 700 were examined with ECV and
716 without. Adjusting for the effects of the colonoscopies, ADR was 39.5% (95% confidence
interval [CI], 32.6%-46.3%) in the ECV group versus 32.2% (95% CI, 25.9%-38.6%) in
the control group, which resulted in an increase of 7.2% (95% CI, 2.3%-12.2%; P = .004). The increase in ADR was mainly because of small polyps, with adjusted ADRs
for adenomas <10 mm of 33.3% (95% CI, 26.5%-40.2%) for study patients versus 24.0%
(95% CI, 18.2%-29.8%) for control patients (P < .001). APC was also significantly increased (.57 ECV vs .51 control subjects, P = .045).
Conclusions
A distal attachment cap with side arms significantly increased the ADR in patients
undergoing primary colonoscopic screening. Because of the correlation of ADR and interval
cancer, its use should be encouraged, especially in this setting. (Clinical trial
registration number: NCT03442738.)
Graphical abstract
Graphical Abstract
Abbreviations:
ADR (adenoma detection rate), APC (adenoma per colonoscopy), CRC (colorectal cancer), EC (Endocuff), ECV (Endocuff Vision)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 28, 2022
Accepted:
August 19,
2022
Received:
February 8,
2022
Footnotes
DISCLOSURE: The following author disclosed financial relationships: T. Rösch: Consultant for Olympus; research support from Olympus, Fujifilm, Erbe, Microtech, and Ovesco. All other authors disclosed no financial relationships. Research support for this study was provided by Norgine Ltd.
Identification
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© 2023 by the American Society for Gastrointestinal Endoscopy
