TORNA ALL’ELENCO

Linked colour imaging versus white-light colonoscopy for adenoma detection: A multicentre, randomised, controlled trial in a fit-based colorectal cancer screening programme in United European Gastroenterology Journal

2019
AOU Città della Salute di Torino

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (20)Vedi tutti...

Paggi S

Radaelli F

Senore C


et alii...

Abstract

Introduction: Linked-Colour Imaging (LCI), a new image-enhanced technology that emphasizes contrast in mucosal colour, has been demonstrated to substantially reduce the miss rate of polyps as compared with standard White-Light (WL) in tandem colonoscopy studies. Whether LCI increases adenoma detection rate (ADR) is still uncertain. Aims & Methods: Consecutive subjects undergoing colonoscopy following a positive faecal immunochemical test (FIT) in the context of regional population-based colorectal cancer screening programmes were randomised (ratio 1:1) to undergo colonoscopy with either LCI or WL. Insertion and withdrawal phase of colonoscopy were both carried out using the same assigned light. Experienced endoscopists from seven Italian centres participated in the study. Randomisation was stratified by gender, age group and screening round, using a randomised blocks design. The planned sample size (300 subjects in each arm) could allow for an 80% power to detect as statistical significant (a = 0.05; two-sided test) a 11.5% and 10.5% absolute increase in the detection rate of adenomas and advanced adenomas. The primary outcome measure was the proportion of patients with at least one adenoma (ADR). Results: Of 704 eligible subjects, 649 were randomised to either LCI (n = 326) or WL (n = 323) colonoscopy and included in the analysis. Overall, 48.9% of patients were male, the mean age±SD was 60.8 ±7.3 years, and 32.5% were at first FIT round, with no differences between the two study arms. The ADR was higher in the LCI group (185/326 patients, 56.5%) than in the WL group (151/323 patients, 43.5%) (p = 0.047; RR for LCI: 1.22, 95%CI 1.03 to 1.43). The proportion of patients with advanced adenomas and sessile serrated polyps was 26.1% and 8.7% in the LCI arm, and 22.0% and 5.0% in the WL arm, respectively (p = NS for both comparisons). Multivariate analysis showed that factors independently influencing ADR were the use of LCI, male gender, age greater than 60 ye

DOI : 10.1177/2050640619888859

Keywords

randomization; polyp; outcome assessment; occult blood test; Massachusetts; multicenter study; male; major clinical study; intestine preparation; human; gender; female; endoscopist; drug withdrawal; controlled study; conference abstract; colorectal cancer; colonoscopy; randomized controlled trial; cancer screening; cancer patient; advanced cancer; adult; adenoma; sample size; white light;