The WASh Trial: water-assisted sigmoidoscopy in the English Bowel Scope Screening Programme: study protocol for a...

Area of Science:

• Gastroenterology
• Public Health Screening
• Medical Technology Innovation

Background:

• The English National Bowel Scope Screening Programme (BSSP) uses flexible sigmoidoscopy (FSIG) for 55-year-olds.
• Participant-reported data indicates significant discomfort in one-third of BSSP participants.
• Water-assisted colonoscopy (WAS) is explored as a method to potentially enhance patient comfort during procedures.

Purpose of the Study:

• To determine if water-assisted colonoscopy (WAS) reduces post-procedural pain compared to carbon dioxide (CO2) insufflation during flexible sigmoidoscopy (FSIG) within the BSSP.
• To evaluate adenoma detection rates (ADR) and sigmoid looping in both WAS and CO2 groups.
• To conduct a cost-effectiveness analysis and explore participant preferences for sigmoidoscopy attributes.

Main Methods:

• A multicenter, prospective, randomized, two-arm, single-blinded trial design.
• Participants undergoing FSIG in the BSSP are randomized to either CO2 or WAS insufflation.
• Pain is assessed post-procedure, with additional analysis of ADR, sigmoid looping, cost-effectiveness, and participant preferences.

Main Results:

• The study is actively recruiting participants.
• No main results are available yet as the trial is ongoing.
• This is the first UK trial of WAS in a screening setting.

Conclusions:

• The trial's findings on pain reduction or improved adenoma detection rates (ADR) with WAS could lead to practice changes.
• Implementation of WAS could impact the 256,000 individuals undergoing BSSP FSIG annually.
• Potential for improved patient experience and screening effectiveness in endoscopic procedures.