Cap-Assisted Chromoendoscopy Using a Mounted Cap Versus Standard Colonoscopy for Adenoma Detection

Area of Science:

• Gastroenterology
• Endoscopy
• Cancer Prevention

Background:

• Neoplastic lesions can be missed during standard colonoscopy.
• Combining cap-assisted colonoscopy with chromoendoscopy has not been previously studied for adenoma detection rate (ADR).

Purpose of the Study:

• To compare the efficacy of cap-assisted chromoendoscopy (CAP/CHROMO) versus standard colonoscopy (SC) in detecting adenomas.

Main Methods:

• A prospective, multicenter, randomized controlled trial involving 1,905 asymptomatic subjects aged 45-75.
• Subjects were randomized to either CAP/CHROMO (with indigo carmine) or SC.
• The primary outcome was ADR, defined as the proportion of subjects with at least one adenoma.

Main Results:

• CAP/CHROMO demonstrated a significantly higher ADR (54.4%) compared to SC (44.9%) (P < 0.001).
• CAP/CHROMO identified more proximal adenomas (38.6%) than SC (31.2%) (P = 0.001).
• Proximal serrated polyp detection was higher in females using CAP/CHROMO.

Conclusions:

• Cap-assisted chromoendoscopy significantly improves ADR and proximal adenoma detection.
• CAP/CHROMO is feasible for routine use, enhancing colon cancer surveillance programs.