Chromoendoscopy for detection of proximal serrated lesions in routine screening colonoscopy
Mené auprès de 741 personnes dont le test de recherche de sang occulte dans les selles s'est révélé positif, cet essai multicentrique évalue la faisabilité et le coût d'une chromocoloscopie pour détecter des néoplasies dentelées ainsi que sa non infériorité, en termes de taux de détection, par rapport à une coloscopie standard
The prevalence of proximal serrated lesions in average-risk patients undergoing screening colonoscopy is estimated to be higher than previously reported.
Colorectal cancer can develop not only via the adenoma-carcinoma sequence, but also via a serrated pathway, with an increase in proximal serrated neoplasia, which could account for up to 20% of cases.
Serrated lesions localised in the right colon have very subtle appearances and are especially easy to miss. Colonoscopy as a screening modality can overlook these lesions, which could explain the absence of a significant reduction in colon cancer originating on the right side with screening colonoscopy. Thus, adequate recognition and detection of such lesions is crucial. Advances in contrast-enhanced endoscopic techniques have aimed to improve the ability to detect any dysplastic lesions, including serrated proximal colon lesions, during colonoscopy exams.
The Lancet Gastroenterology & Hepatology , commentaire, 2018