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- Title
Chromoendoscopy Is Not Superior to White Light Endoscopy in Improving Adenoma Detection in Lynch Syndrome Cohort Undergoing Surveillance with High-Resolution Colonoscopy: A Real-World Evidence Study.
- Authors
Montale, Amedeo; Buttitta, Francesco; Pierantoni, Chiara; Ferrari, Clarissa; Cameletti, Michela; Colussi, Dora; Miccoli, Sara; Bazzoli, Franco; Turchetti, Daniela; Ricciardiello, Luigi
- Abstract
Background: Endoscopic surveillance in patients with Lynch syndrome (LS) is crucial due to a genetically based high risk of colorectal cancer (CRC). We aimed to compare the adenoma detection rate (ADR) between high-resolution white light endoscopy (WLE) alone and WLE plus dye chromoendoscopy (CE) in a cohort of LS patients. Methods: In a context of real-world data, we retrospectively enrolled 50 LS patients who had non-randomly undergone WLE versus CE surveillance examinations from 2007 to 2019. The 2 groups were compared at baseline (BL) in terms of the rate of patients with lesions and the number of lesions, and at follow-up (FU), to evaluate a possible enhanced detection rate. Longitudinal analysis of the effect of the endoscopy type on the main outcomes was performed by generalized linear mixed models. Results: Forty-two patients had undergone at least one diagnostic colonoscopy. At BL and at FU analysis, we found no significant differences in detection rates and clinical-pathological features between WLE and CE groups. At the longitudinal analysis, an increase in the endoscopy rank (i.e., the position of each colonoscopy for all the colonoscopies that a patient had undergone) was associated with an increase in polyp detection rate (p = 0.006) and ADR (p = 0.005), while a trend toward significance (p = 0.069) was found for endoscopy type (CE vs. WLE) in the detection of serrated lesions. Conclusions: CE is not superior to high-resolution WLE in increasing the ADR. Even under standard WLE, an active and careful endoscopic surveillance of LS patients can prevent CRC.
- Subjects
ADENOMA; HEREDITARY nonpolyposis colorectal cancer; VIRTUAL colonoscopy; BOWEL preparation (Procedure); COLONOSCOPY; COLORECTAL cancer; ENDOSCOPY; DISEASE risk factors
- Publication
Digestive Diseases, 2022, Vol 40, Issue 4, p517
- ISSN
0257-2753
- Publication type
Article
- DOI
10.1159/000518840