Adenoma detection by Endocuff-assisted versus standard colonoscopy in an organized screening program: the "ItaVision"...

Area of Science:

• Gastroenterology
• Colorectal Cancer Screening
• Medical Device Technology

Background:

• The Endocuff Vision device enhances mucosal exposure during colonoscopy, potentially improving adenoma detection rates (ADR).
• Its efficacy within a fecal immunochemical test (FIT)-based screening program requires evaluation for both benefits and harms.

Purpose of the Study:

• To assess the benefits and harms of using the Endocuff Vision device in a nationwide multicenter FIT-based colonoscopy screening program.
• To determine if Endocuff Vision improves adenoma detection rate (ADR) compared to standard colonoscopy.

Main Methods:

• A randomized controlled trial comparing Endocuff-assisted colonoscopy with standard colonoscopy in patients with a positive FIT result.
• Primary outcome was ADR; secondary outcomes included advanced ADR (AADR), adenomas per colonoscopy (APC), withdrawal time, and adverse events.

Main Results:

• Endocuff Vision significantly increased ADR (47.8% vs. 40.8%) and APC (0.94 vs. 0.77) compared to standard colonoscopy.
• The ADR increase was statistically significant only among endoscopists with a low baseline ADR (<33.3%).
• No significant differences were observed in adenoma size, morphology, withdrawal time, or adverse events.

Conclusions:

• Endocuff Vision enhances ADR in FIT-based screening by improving colonic mucosa examination.
• The device demonstrates particular utility for endoscopists with lower ADR, suggesting a role in standardizing screening quality.