A149 COMPARING THE REAL-WORLD EFFECTIVENESS OF 4L VERSUS 2L SPLIT COLONOSCOPY PREPARATIONS: PRELIMINARY DATA OF A SINGLE CENTRE EXPERIENCE THROUGH THE BRITISH COLUMBIA COLONOSCOPY SCREENING PROGRAM

Abstract Background The British Columbia Colon Screening Program (CSP) is a population-based program offering biennial fecal immunochemical test (FIT) to individuals age 50–74 years with follow-up colonoscopy for a positive FIT as well as individuals with a personal history of neoplastic polyps or a high risk family history of colorectal cancer. Over 20,000 colonoscopies are performed annually. In December 2018, program colonoscopists in Vancouver, Canada agreed to switch from a 2L polyethylene glycol (PEG) preparation to a 4L PEG preparation after studies suggested superiority of the higher volume preparation in achieving adequate bowel cleansing and improving adenoma detection rates (ADR). High quality bowel cleansing is critical to minimize repeat procedures and maximize neoplasia detection. Aims To compare the quality of bowel preparation and neoplasia detection rates using the 4L high volume split preparation (HVSP) versus the 2L low volume split preparation (LVSP) in patients undergoing colonoscopy in the BC CSP. Methods A retrospective review of consecutive patients undergoing colonoscopy through the CSP at St. Paul’s Hospital from Dec 2017-Apr 2018 and Dec 2018-Apr 2019 was conducted. Inclusion criteria included: age 50–74, patients undergoing colonoscopy for any reason through the BC CSP. Variables collected included: patient demographics, bowel preparation qualty and pathologic findings. ADR and sessile serrated polyp detection rate (SSDR) were analyzed. Results 462 colonoscopies were included, 280 in the LVSP group and 182 in the HVSP group. 8/280 (2.9%) had poor bowel preparation in the LVSP group, while 10/182 (5.5%) had poor bowel preparation in the HVSP group. The ADR and SSDR were 53.6% in LVSP vs. 50.0% in HVSP and 8.2% in LVSP vs. 8.8% in HVSP, respectively. Conclusions In this preliminary evaluation, the high volume PEG-based split preparation did not reduce the proportion of inadequate bowel preparations. Further evaluation of a larger number of colonoscopies is planned. Funding Agencies None

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Comparing the Real-World Effectiveness of High- Versus Low-Volume Split Colonoscopy Preparations: An Experience Through the British Columbia Colon Cancer Screening Program

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwaa031 ◽

2020 ◽

Author(s):

Joseph G H Lee ◽

Jennifer J Telford ◽

Cherry Galorport ◽

Jordan Yonge ◽

Christopher A Macdonnell ◽

...

Keyword(s):

Colon Cancer ◽

Bowel Preparation ◽

Detection Rate ◽

Screening Program ◽

High Volume ◽

Colon Cancer Screening ◽

Detection Rates ◽

Cancer Screening Program ◽

Adenoma Detection ◽

Low Volume

Abstract Background The British Columbia Colon Screening Program (BCCSP) is a population-based colon cancer screening program. In December 2018, physicians in Vancouver, Canada agreed to switch from a low-volume split preparation to a high-volume polyethylene glycol preparation after a meta-analysis of studies suggested superiority of the higher volume preparation in achieving adequate bowel cleansing and improving adenoma detection rates. Aims To compare the quality of bowel preparation and neoplasia detection rates using a high-volume split preparation (HVSP) versus a low-volume split preparation (LVSP) in patients undergoing colonoscopy in the BCCSP. Methods A retrospective review of patients undergoing colonoscopy through the BCCSP at St. Paul’s Hospital from July 2017 to November 2018 and December 2018 to November 2019 was conducted. Inclusion criteria included age 50 to 74 and patients undergoing colonoscopy through the BCCSP. Variables collected included patient demographics and bowel preparation quality. Rates of bowel preparation and neoplasia detection were analyzed using chi-squared test. Results A total of 1453 colonoscopies were included, 877 in the LVSP group and 576 in the HVSP group. No statistically significant difference was noted between rates of inadequate bowel preparation (LVSP 3.6% versus HVSP 2.8%; P = 0.364). Greater rates of excellent (48.4% versus 40.1%; P = 0.002) and optimal (90.1% versus 86.5%; P = 0.041) bowel preparation were achieved with HVSP. The overall adenoma detection rate was similar between the two groups (LVSP 53.1% versus HVSP 54.0%; P = 0.074). LVSP demonstrated higher overall sessile serrated lesion detection rate (9.5% versus 5.6%; P = 0.007). Conclusions Compared to LVSP, HVSP was associated with an increase in excellent and optimal bowel preparations, but without an improvement in overall neoplasia detection.

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Efficacy and Patient Tolerability Profiles of Probiotic Solution with Bisacodyl Versus Conventional Cleansing Solution for Bowel Preparation: A Prospective, Randomized, Controlled Trial

Journal of Clinical Medicine ◽

10.3390/jcm9103286 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3286

Author(s):

Youn I Choi ◽

Jong-Joon Lee ◽

Jun-Won Chung ◽

Kyoung Oh Kim ◽

Yoon Jae Kim ◽

...

Keyword(s):

Bowel Preparation ◽

Detection Rate ◽

Controlled Trial ◽

Screening Colonoscopy ◽

Control Group ◽

Case Group ◽

Detection Rates ◽

Polyp Detection Rate ◽

Adenoma Detection ◽

Bowel Cleansing

Although adequate bowel preparation is essential in screening colonoscopy, patient intolerability to bowel cleansing agents is problematic. Recently, a probiotic mixture solution with bisacodyl emerged to improve patient tolerability. We investigated the efficacy, safety, and patient tolerability profiles of probiotics with bisacodyl versus conventional polyethylene glycol (PEG) solution for bowel preparation for screening colonoscopies in healthy patients in this prospective, randomized, case-control study. In total, 385 volunteers were randomly assigned to receive 2 L of water + 200 mL of probiotic solution (case group, n = 195) or 4 L of PEG solution (control group, n = 190). The efficacy of the bowel cleansing was evaluated using the Ottawa scale system, polyp detection rate, and adenoma detection rate, and the patient tolerability profiles were assessed using a questionnaire. The demographics were not significantly different between groups. When the Ottawa score for each bowel segment was stratified into an adequate vs. inadequate level (Ottawa score ≤ 3 vs. >3), there were no statistical differences between groups in each segment of the colon. There were no significant differences in the polyp and adenoma detection rates between groups (38.42% vs. 32.42, p = 0.30; 25.79% vs. 18.97%, p = 0.11). The case group showed significantly fewer events than the control group, especially nausea, vomiting, and abdominal bloating events. Regarding the overall satisfaction grade, the case group reported significantly more “average” scores (95% vs. 44%, p < 0.001) and were more willing to use the same agents again (90.26% vs. 61.85%, p < 0.001). As patient compliance with bowel preparation agents is associated with an adequate level of bowel cleansing, a probiotic solution with bisacodyl might be a new bowel preparation candidate, especially in patients who show a poor compliance with conventional bowel preparation agents.

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Tu1148 ADENOMA DETECTION RATES WITH 1 L NER1006 BOWEL PREPARATION EXCEED MINIMUM THRESHOLD RECOMMENDATIONS IN COLONOSCOPY SCREENING POPULATION AND NER1006 DEMONSTRATES OVERALL BOWEL CLEANSING SUCCESS REGARDLESS OF COLONOSCOPY INDICATION

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2020.03.3320 ◽

2020 ◽

Vol 91 (6) ◽

pp. AB566

Author(s):

Phillip Schoenfeld ◽

David M. Poppers ◽

Sarah Lorenzen ◽

Prateek Sharma

Keyword(s):

Bowel Preparation ◽

Minimum Threshold ◽

Detection Rates ◽

Colonoscopy Screening ◽

Adenoma Detection ◽

Bowel Cleansing ◽

Screening Population ◽

Adenoma Detection Rates

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Different schedules of bowel preparation with sodium phosphate lead to different bowel cleansing effects and adenoma detection rates at colonoscopy

Advances in Digestive Medicine ◽

10.1016/j.aidm.2014.03.005 ◽

2014 ◽

Vol 2 (1) ◽

pp. 12-17

Author(s):

Jui-Wen Kang ◽

Chiao-Hsiung Chuang ◽

Chiung-Yu Chen ◽

Hsiu-Chi Cheng ◽

Wei-Lun Chang ◽

...

Keyword(s):

Bowel Preparation ◽

Sodium Phosphate ◽

Detection Rates ◽

Adenoma Detection ◽

Bowel Cleansing ◽

Adenoma Detection Rates

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Colon Irrigation Bowel Preparation Supports Multiple Clinical Benefits in Over 8,000 Patients

Open Journal of Gastroenterology and Hepatology ◽

10.28933/ojgh-2021-02-1605 ◽

2021 ◽

pp. 48

Author(s):

Keyword(s):

Bowel Preparation ◽

High Volume ◽

Serious Adverse Events ◽

Detection Rates ◽

Serrated Polyp ◽

Adenoma Detection ◽

Retrospective Clinical Study ◽

Clinical Benefits ◽

Colon Irrigation ◽

High Level

This retrospective clinical study evaluates an FDA-cleared high-volume colon irrigation bowel prep (BP) for colonoscopy, performed under standard operating procedures with Austin Gastroenterology (AG, Austin, TX). Patient related outcomes in 8,364 procedures, prescribed by 33 physicians in 4.5 years, demonstrated no serious adverse events and excellent satisfaction rates. The high level of adequacy using this BP far exceeds national benchmarking thresholds for adequate colon preparations. Adequacy rates remain high even when considering poor BP risk factors and patient noncompliance with ancillary pre-preparation regimens. Our analysis demonstrates that this colon irrigation BP has excellent Boston bowel preparation scores (BBPS), associated with high-level adenoma detection rates (ADR) and sessile serrated polyp (SSP) detection rates. ADR and SSP are inversely related to the patient’s post-colonoscopy interval colorectal cancer (CRC) risk, and are similarly related to an inadequate BP. Both modeling data and performance characteristics strongly suggest that this colon irrigation BP is highly safe, effective, and will reduce the costs and risks related to inadequate BP. This, accordingly, leads to significantly improved quality outcomes, savings to the healthcare systems, and a reduction of the patient’s burden.

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Mo1081 Effect of a Low-Volume Compared to a High-Volume Polyethylene Glycol Bowel Preparation Solution on Prep Quality, Procedure Times, and Adenoma Detection Rates

Gastroenterology ◽

10.1016/s0016-5085(14)61996-x ◽

2014 ◽

Vol 146 (5) ◽

pp. S-552

Author(s):

Bryan B. Brimhall ◽

Sam C. Hankins ◽

Gregory L. Austin

Keyword(s):

Polyethylene Glycol ◽

Bowel Preparation ◽

High Volume ◽

Detection Rates ◽

Adenoma Detection ◽

Adenoma Detection Rates ◽

Low Volume

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Effect of physician-provided education on the quality of bowel preparation

Acta Gastro Enterologica Belgica ◽

10.51821/84.3.009 ◽

2021 ◽

Vol 84 (3) ◽

Author(s):

B Dikkanoğlu ◽

A.E. Duman ◽

S Hülagü

Keyword(s):

Bowel Preparation ◽

Control Group ◽

Procedure Time ◽

Cecal Intubation ◽

Detection Rates ◽

Written Information ◽

Polyp Detection Rate ◽

Adenoma Detection ◽

Inadequate Bowel Preparation

Background and study aims : Inadequate bowel preparation inpatients scheduled for colonoscopy is an important problem. Inour study, we aimed to investigate the effect of physician-providedbowel preparation education on the quality of bowel preparationand process. Patients and methods : A total of 150 outpatients who were referredto Kocaeli University Medical Faculty Hospital GastroenterologyUnit for colonoscopy between May 2019 and October 2019 wereenrolled in our prospective, endoscopist-blinded study. Patientswere divided into two groups. Group 1 (education group) included73 patients who received 10 minutes of verbal information froma physician in addition to a written information form. Group 2(control group) included 75 patients who received informationfrom a medical secretary in addition to a written information form.During colonoscopy, the quality of bowel preparation was assessedusing the Boston bowel preparation scale (BBPS). A BBPS score≥ 5 was considered adequate bowel preparation. The mean BBPSscore, polyp detection rate, cecal intubation rate and time, andprocedure time were also evaluated. Results : The rate of adequate bowel preparation (BBPS score≥ 5) was 90.4% and 74.7% in groups 1 and 2, respectively (p =0.021). The odds ratio for having a BBPS score ≥ 5 in the educationgroup was 3.199 compared with the control group (95% confidenceinterval = 1.254-8.164; p = 0.015). The cecal intubation rates were91.8% and 88% in groups 1 and 2, respectively (p > 0.05). The cecalintubation time, procedure time, and adenoma detection rates weresimilar between the groups. The relationships of age, educationlevel, sex, diabetes mellitus, medicine use, procedure time, andintraabdominal surgery with inadequate bowel preparationwere analysed using a logistic regression model. Univariate andmultivariate analyses revealed no significant factors associatedwith inadequate bowel preparation. Conclusions : Patient education on the bowel preparationprocess via a physician improved the quality of bowel preparation.

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Opportunistic Colorectal Cancer Screening using Colonoscopy. Comparative Results between two Historical Cohorts in Bucharest, Romania

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.242.buch ◽

2015 ◽

Vol 24 (2) ◽

pp. 171-176 ◽

Cited By ~ 1

Author(s):

Elena Mirela Ionescu ◽

Tudor Nicolaie ◽

Serban Ion Gologan ◽

Ana Mocanu ◽

Cristina Ditescu ◽

...

Keyword(s):

Colorectal Cancer ◽

Screening Program ◽

Advanced Adenoma ◽

Detection Rates ◽

Incidence And Mortality ◽

Organized Screening Program ◽

History Of ◽

Comparative Results ◽

Asymptomatic Individuals ◽

Second Period

Background & Aims: Even though Romania has one of the highest incidence and mortality in colorectal cancer (CRC) in Europe, there is currently no organized screening program. We aimed to assess the results of our opportunistic CRC screening using colonoscopy.Methods: A single center retrospective study to include all opportunistic screening colonoscopies performed in two 18 month periods (2007-2008 and 2012-2013) was designed. All asymptomatic individuals without a personal or family history of adenoma or CRC and with complete colonoscopy performed in these two time periods were included.Results: We included 1,807 individuals, 882 in the first period, 925 in the second period. There were 389 individuals aged below 50, 1,351 between 50 and 75 and 67 older than 75 years. There were 956 women (52.9%), with a mean age of 58.5 (median 59, range 23-97). The detection rates were 12.6% for adenomas (6.1% for advanced adenoma) and 3.4% for adenocarcinoma. Adenoma incidence (4.9% in subjects under 50, 14.7% in those aged 50 to 75, and 16.4% in those older than 75, p<0.0001) and size (6.3mm in subjects younger than 50, 9.2mm in those 50 to 75 and 10.8mm in those older than 75, p=0.015) significantly increased with age. Adenoma incidence increased in the second period (14.8% vs. 10.3%, p=0.005), while adenoma size decreased in the second period (8.4mm vs. 10mm, p=0.006). There were no procedure related complications.Conclusions: The neoplasia detection rate was 16% (12.6% adenoma, 3.4% adenocarcinoma). Adenoma incidence and size increased with age in both cohorts. In the second screening period significantly more and smaller adenomas were detected.

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Comparison of colonoscopy after colonic diverticulitis and positive fecal immunochemical tests for the detection of colorectal neoplasia

Endoscopy International Open ◽

10.1055/a-1333-1108 ◽

2021 ◽

Vol 09 (03) ◽

pp. E331-E337

Author(s):

Dai Nakamatsu ◽

Tsutomu Nishida ◽

Shinji Kuriki ◽

Li-sa Chang ◽

Kazuki Aochi ◽

...

Keyword(s):

Detection Rate ◽

Colorectal Neoplasia ◽

Acute Diverticulitis ◽

Colonic Diverticulitis ◽

Detection Rates ◽

Positive Group ◽

Asymptomatic Patients ◽

Polyp Detection Rate ◽

Adenoma Detection ◽

Acute Colonic Diverticulitis

Abstract Background and study aims The relationship between acute colonic diverticulitis and colorectal cancer (CRC) is unclear, but colonoscopy is recommended to exclude malignancy. We compared the detection rates for colorectal neoplasia in patients with colonic diverticulitis and asymptomatic patients who had positive fecal immunochemical tests (FITs). Patients and methods In total, 282 patients with acute colonic diverticulitis were hospitalized in our hospital from February 2011 to December 2019. Of them, 143 patients with diverticulitis and 1819 with positive FITs patients during the same period underwent colonoscopy without a prior colonoscopy within 5 years. We retrospectively compared these patients in terms of the invasive CRC rate, advanced neoplasia detection rate (ANDR), adenoma detection rate (ADR), and polyp detection rate (PDR). Results Compared to the diverticulitis group, the FIT-positive group had a significantly higher CRC rate (0 vs 2.7 %, P = 0.0061), ANDR (5.6 vs. 14.0 %, P = 0.0017), ADR (19.6 vs. 53.2 %, P < .0001), and PDR (44.1 vs. 91.0 %, P < .0001). Using 1:1 propensity score matching based on age and sex, we obtained 276 matched patients in both groups. After matching, no difference was found in the CRC rate (0 vs 0.7 %) or ANDR (5.8 vs 7.3 %) between groups, but the ADR and PDR were significantly higher in the FIT-positive group (20.3 vs 43.5 %, P < .0001; 45.7 % vs 86.2 %, P < .0001). Conclusion Patients with acute diverticulitis had lower ADRs and PDRs than patients with positive FITs.

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