Improved detection of colorectal adenomas by high-quality colon cleansing
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- dc.contributor.author Hassan, Cesare
- dc.contributor.author Manning, Jonathan R.
- dc.contributor.author Álvarez González, Marco Antonio
- dc.contributor.author Sharma, Prateek
- dc.contributor.author Epstein, Michael
- dc.contributor.author Bisschops, Raf
- dc.date.accessioned 2020-12-09T09:03:46Z
- dc.date.available 2020-12-09T09:03:46Z
- dc.date.issued 2020
- dc.description.abstract Background and study aims: Reliable adenoma detection requires "adequate" bowel preparation. The adenoma detection rate (ADR) was assessed in patients with high-quality (stool-free) cleansing versus adequate cleansing. Patients and methods: This study was a post-hoc combined analysis of three randomized trials individually powered for cleansing quality assessment. Treatment-independent ADR was assessed versus colon cleansing quality by central readers using the Harefield Cleansing Scale (HCS) and the Boston Bowel Preparation Scale (BBPS). The number needed to treat (NNT) to find an additional patient with at least one adenoma was calculated for high-quality versus adequate-quality cleansing. Results: A total of 1749 patients were included. ADR increased with high-quality versus adequate-quality cleansing: HCS grade A versus B, 39 % (94/242) versus 27 % (336/1229); NNT = 8.7; P < 0.001. ADR also increased with high-quality versus uniform adequate segmental cleansing scores: HCS grade A versus uniform segmental scores 2, 39 % (94/242) versus 26 % (97/379); NNT = 7.5; P < 0.001. ADR increased with top-quality versus adequate segmental cleansing scores: HCS uniform segmental scores 4 versus 2, 54 % (21/39) versus 26 % (97/379); NNT = 3.6; P < 0.001. ADR increased with BBPS 9 versus 6, 43 % (71/166) versus 26 % (247/950); NNT = 6.0; P < 0.001. Right colon ADR increased with top-quality versus adequate cleansing: HCS 4 versus 2, 20 % (25/122) versus 11 % (121/1117); NNT = 10.4; P < 0.001 and BBPS 3 versus 2, 15 % (42/284) versus 11 % (130/1192); NNT = 25.8; P = 0.033. Conclusions: High-quality colon cleansing improves adenoma detection, and it should be a priority for bowel preparations for colonoscopy.
- dc.format.mimetype application/pdf
- dc.identifier.citation Hassan C, Manning J, Álvarez González MA, Sharma P, Epstein M, Bisschops R. Improved detection of colorectal adenomas by high-quality colon cleansing. Endosc Int Open. 2020 Jul; 8(7):E928-37. DOI: 10.1055/a-1167-1359
- dc.identifier.doi http://dx.doi.org/10.1055/a-1167-1359
- dc.identifier.issn 2196-9736
- dc.identifier.uri http://hdl.handle.net/10230/45957
- dc.language.iso eng
- dc.publisher Thieme Open
- dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
- dc.subject.other Adenoma
- dc.subject.other Còlon -- Malalties
- dc.title Improved detection of colorectal adenomas by high-quality colon cleansing
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion