January 29, 2014—Using a balloon-assisted colonoscope for colon cancer screening may be effective in increasing polyp and adenoma (a potentially pre-cancerous type of polyp) detection rates, according to study results presented by
Seth A. Gross, MD, director of endoscopy at Tisch Hospital, NYU Langone Medical Center, at the 2013 American College of Gastroenterology Annual Scientific Meeting in San Diego.
“During a screening colonoscopy, a physician uses a thin, flexible scope to view the inside of the colon and detect and remove any potentially pre-cancerous growths, or polyps,” Dr. Gross explained. While several tests are available for colon cancer screening, a colonoscopy is considered the most comprehensive because it allows for examination of the entire colon as well as both the detection and removal of polyps during the same procedure. “In addition, a colonoscopy is considered a preventive test, because when we remove a potentially pre-cancerous polyp, we prevent that colon cancer from developing,” he said.
Because no test, including colonoscopy, is perfect, Dr. Gross and other gastroenterologists have been working to optimize adenoma detection rates and other quality measures with this procedure. One way to do this is to ensure that physicians performing colonoscopies are trained and focused on meeting designated national quality metrics, such as withdrawal time, cecal intubation, and adenoma detection rates.
“Another important approach to increasing our ability to detect polyps is to pursue innovative technologies and methods to enhance our ability to view the colon during a colonoscopy exam,” said Dr. Gross. One new technology under study is a balloon-assisted colonoscope. This new modality involves fitting a traditional colonoscope with an integrated and reusable balloon. When the scope reaches the cecum (end of the colon), the balloon is inflated, and withdrawal of the scope begins. As the scope is withdrawn, the balloon acts to flatten or smooth out folds on the inside wall of the colon, allowing potentially hidden polyps to be better visualized.
In a recent multicenter tandem study, Dr. Gross and colleagues compared balloon-assisted colonoscopy with traditional colonoscopy. In one group of patients, the balloon-assisted colonoscopy was done first and was followed by traditional colonoscopy. In a second group, the traditional colonoscopy was done first and was followed by the balloon procedure. The researchers evaluated several quality endpoints, including polyp and adenoma detection rates.
“Overall, we found improved polyp and adenoma detection rates with the balloon-assisted colonoscopy. More studies are needed, but this new technology appears promising for increasing our ability to visualize and remove more adenomas,” Dr. Gross concluded.
The balloon-assisted colonoscope [G-Eye] is approved in Europe, and is being considered for approval by the U.S. Food and Drug Administration. Other recent innovations designed to enhance colonoscopy imaging include Third-Eye Retroscope, Endocuff, and Full-Spectrum Endoscopy (FUSE) technologies.