Published in:
01-02-2013 | Editorial
Can Cap-Assisted Colonoscopy Be a Savior for Right Side Interval Cancer?
Author:
Hyung Hun Kim
Published in:
Digestive Diseases and Sciences
|
Issue 2/2013
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Excerpt
There is no doubt that effective colorectal cancer screening relies on early identification and removal of polyps with neoplastic potential [
1,
2]. Although colonoscopy is regarded as the best method for detecting colonic neoplasm, it does have limitations. Right-sided lesions, flat polyps, and variable detection of endoscopist adenoma are all reasons why polyps are missed and interval cancers develop after a negative screening colonoscopy. Successful colorectal cancer protection by colonoscopy depends on complete intubation of the colon combined with careful and complete visualization of the colonic mucosal surface on withdrawal. A large population-based study showed that failure to intubate the cecum is not uncommon, especially for less experienced endoscopists; it was estimated to occur in 13.1 % of attempted colonoscopies [
3]. Furthermore, occurrence of missed adenoma ranging from 13 to 26 % has been reported [
4]. Adenoma detection has been shown to be an independent predictor of the risk of interval colorectal cancer after screening colonoscopy [
5]. Several types of new technology have therefore been developed to improve adenoma detection, including high-definition white-light colonoscopy, pan-chromoendoscopy, wide-angle colonoscopy, virtual chromoendoscopy, third-eye retroscopy (TER), and cap-assisted colonoscopy (CAC) [
6]. …