Adenoma detection with cap-assisted colonoscopy versus regular colonoscopy: a randomised controlled trial

Area of Science:

• Gastroenterology
• Endoscopy
• Colorectal Cancer Screening

Background:

• Conventional colonoscopy (CC) is the standard for detecting colorectal neoplasia but has limitations in adenoma detection.
• Transparent plastic caps may enhance colonic visualization during colonoscopy.

Purpose of the Study:

• To compare the efficacy of cap-assisted colonoscopy (CAC) versus CC in adenoma detection.
• To evaluate secondary outcomes including caecal intubation time, rate, and patient discomfort.

Main Methods:

• A parallel, randomized controlled trial involving 1380 asymptomatic participants aged 50-75 years.
• Participants were randomized 1:1 to either CAC or CC, performed by experienced endoscopists.
• Colonoscopy quality indicators, including adenoma detection and patient comfort, were prospectively recorded.

Main Results:

• Adenoma detection rates were similar between CAC and CC groups (28% vs 28%).
• Caecal intubation time was significantly shorter with CAC (7.7 min vs 8.9 min, p<0.001).
• Patients reported significantly less discomfort with CAC (Gloucester Comfort Scores 2.0 vs 2.2, p=0.03).

Conclusions:

• Cap-assisted colonoscopy (CAC) does not improve adenoma detection rates compared to conventional colonoscopy (CC).
• CAC offers significant benefits by reducing caecal intubation time and patient discomfort.
• These findings suggest CAC may enhance the colonoscopy experience without compromising diagnostic yield.