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Second-generation distal attachment cuff for adenoma detection in screening colonoscopy: a randomized multicenter

Katharina Zimmermann-Fraedrich¹, Susanne Sehner², Thomas Rösch¹

¹Department of Interdisciplinary Endoscopy, University Hospital Hamburg-Eppendorf, Hamburg, Germany.

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|August 28, 2022

Summary

The Endocuff Vision (ECV) significantly improved adenoma detection rates (ADR) during colonoscopic screening. This device enhances the detection of small polyps, potentially reducing interval cancers.

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Area of Science:

Gastroenterology
Endoscopy
Cancer Screening

Background:

Previous studies show Endocuff Vision (ECV) increases adenoma detection rate (ADR).
This is the first study to assess ECV in primary colonoscopic screening.

Purpose of the Study:

To evaluate the efficacy of ECV in a primary colonoscopic screening program.
To compare ADR and adenoma per colonoscopy (APC) rates between ECV and standard high-definition colonoscopy.

Main Methods:

A randomized controlled trial involving 1416 patients aged over 55 undergoing screening colonoscopy.
Patients were assigned to either the ECV group or the standard high-definition colonoscopy (control) group.
Primary outcome was ADR; secondary outcomes included APC and detection of adenoma subgroups.

Main Results:

The ECV group showed a significantly higher ADR (39.5%) compared to the control group (32.2%), an increase of 7.2% (P=.004).
The improvement was primarily driven by increased detection of small adenomas (<10 mm).
Adenomas per colonoscopy (APC) was also significantly higher in the ECV group (.57 vs .51, P=.045).

Conclusions:

Endocuff Vision significantly increases ADR in primary colonoscopic screening.
Given the link between ADR and interval cancers, ECV use is recommended for screening colonoscopies.