LINKED COLOR IMAGING VERSUS WHITE-LIGHT COLONOSCOPY FOR ADENOMA DETECTION: A MULTICENTRE, RANDOMISED, CONTROLLED TRIAL IN A FIT-BASED COLORECTAL CANCER SCREENING PROGRAMME in Digestive and Liver Disease
2020
AOU Città della Salute di Torino
Tipo pubblicazione
Conference Abstract
Autori/Collaboratori (21)Vedi tutti...
Paggi S
Ospedale Valduce, Como, Italy
Radaelli F
Ospedale Valduce, Como, Italy
Senore C
CPO, Città della Salute e della Scienza, Torino, Italy
et alii...
Abstract
Background and aim: Linked-Color Imaging (LCI), a new image-enhanced technology that emphasizes contrast in mucosal color, has been demonstrated to substantially reduce the miss rate of polyps as compared with standard White-Light (WL) in tandem colonoscopy studies. Present randomized controlled trial is aimed at evaluating whether LCI increases adenoma detection rate (ADR) in the context of a population-FIT based organised CRC screening programme,. Materials and methods: Consecutive subjects undergoing screening colonoscopy following a positive faecal immunochemical test (FIT) were randomised (ratio 1:1) to undergo colonoscopy with either LCI or WL, both in high-definition systems. Insertion and withdrawal phase of colonoscopy were both carried out using the same assigned light for each procedure. Experienced endoscopists from seven Italian centres participated in the study. Randomisation was stratified by gender, age group and screening round. The primary outcome measure was the proportion of patients with at least one adenoma. Results: Of 704 eligible subjects, 649 (48.9% males, mean age+SD 60.8+7.3 years) were randomised to either LCI (n=326) or WL (n=323) colonoscopy and included in the analysis. The ADR was higher in the LCI group (185/326 patients, 56.5%) than in the WL group (151/323, 46.7%) (p=0.047; RR for LCI: 1.21, 95% CI 1.04 to 1.41). The proportion of patients with advanced adenomas and sessile serrated polyps (SSA/Ps) was 26.1% and 9.2% in the LCI arm, and 22.0% and 6.2% in the WL arm, respectively, with no significant difference for both comparisons. At multivariate analysis LCI was independently associated with ADR, along with male gender, age greater than 60 years, and adequate (Boston Bowel Preparation Scale >6) bowel preparation. At per-polyp analysis, the mean number (SD) of adenomas per colonoscopy was 1.13 (1.58) and 0.99 (1.47) in the LCI and WL arm, respectively (p=0.24). The corresponding figure for proximal adenomas was significant
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DOI : 10.1016/S1590-8658(20)30507-7
Keywords
adenoma; adult; advanced cancer; cancer patient; cancer screening; colonoscopy; colorectal cancer; conference abstract; controlled study; drug withdrawal; endoscopist; female; gender; groups by age; human; intestine preparation; major clinical study; male; Massachusetts; multicenter study; occult blood test; outcome assessment; polyp; randomization; randomized controlled trial; white light;