[Screening: management after incomplete colonoscopy could be improved].

Area of Science:

• Gastroenterology
• Oncology
• Medical Imaging

Background:

• The Dutch national bowel cancer screening program (since 2014) uses colonoscopy after positive fecal occult blood tests.
• Incomplete colonoscopies necessitate alternative imaging, currently CT colonography (CTC).

Purpose of the Study:

• To evaluate Balloon Endoscopy (BE) as an alternative to CTC for incomplete colonoscopies within the national screening program.
• To assess the advantages and disadvantages of BE compared to CTC.

Main Methods:

• Review of existing literature and clinical guidelines on BE and CTC in colorectal cancer screening.
• Comparative analysis of efficacy, safety, cost, and procedural aspects of BE and CTC.

Main Results:

• BE is an effective and safe endoscopic alternative to CTC, offering polypectomy and histological examination.
• BE's disadvantages include higher cost and the need for a separate procedure day.
• BE is particularly valuable when polyps are detected via CTC.

Conclusions:

• BE should be integrated into the national screening program as an alternative to CTC after incomplete colonoscopies.
• Establishing designated referral centers for BE is crucial due to limited expertise and availability.