Improving polyp detection at colonoscopy: Non-technological techniques

Abstract

Colonoscopy and polypectomy remain the gold standard investigation for the detection and prevention of colorectal cancer. Halting the progression of colonic adenoma through adequate detection of pre-cancerous lesions interrupts the progression to carcinoma. The adenoma detection rate is a key performance indicator. Increasing adenoma detection rates are associated with reducing rates of interval colorectal cancer. Endoscopists with high baseline adenoma detection rate have a meticulous technique during colonoscopy withdrawal that improves their adenoma detection. This minireview article summarizes the evidence on the following simple operator techniques and their effects on the adenoma detection rate; minimum withdrawal times, dynamic patient position change and proximal colon retroflexion.

Keywords: Colonoscopy; Minimum withdrawal times; Dynamic position change; Proximal colon retroflexion

Core Tip: Excellent endoscopists use effective mucosal exposure techniques to increase their adenoma detection rate. This minireview summarizes some of the non-technological techniques that have shown the potential to improve the adenoma detection rate.