Douglas K. Rex, MD, MASGE reviewing Kastrinos F, et al. Gastroenterology 2021 Apr 8.

Lynch syndrome is associated with increased cancer risk, particularly in the colorectum, as a result of germline mutations in any of 4 mismatch repair genes. In a modeling study, researchers analyzed the optimal surveillance strategy for each mismatch repair gene.

Douglas K. Rex, MD, MASGE reviewing Zorzi M, et al. Gut 2021 Mar 31.

In an Italian study using a fecal immunochemical test (FIT)-positivity cutoff of 20 µg Hb/g feces, 88,013 FIT-positive patients (79%) underwent colonoscopy, and 23,410 (21%) did not. Researchers investigated whether patients who failed to obtain a colonoscopy after a positive FIT had higher colorectal cancer and mortality rates.

Douglas K. Rex, MD, MASGE Idos GE, et al. Clin Transl Gastroenterol 2021 Feb.

According to recent studies, follow-up colonoscopy rates are low after positive fecal immunochemical testing (FIT). These authors established a patient navigation program and evaluated its effectiveness by comparing colonoscopy adherence rates after abnormal FIT to rates from a previous year without patient navigation.

Douglas K. Rex, MD, MASGE reviewing Kaltenbach T, et al. Clin Gastroenterol Hepatol 2021 Feb 18.

When the adenoma detection rate (ADR) was originally proposed as a quality measure in 2002, the recommendation did not constrain its indication to screening colonoscopies; the recommendation to limit the use of ADR measurement to screening colonoscopies was made in 2006. These researchers sought to prove that ADR for screening, surveillance, and diagnostic examinations combined is similar to screening ADR alone.

Douglas K. Rex, MD, MASGE reviewing Zorzi M, et al. Endoscopy 2021 Feb 1.

Recent analyses suggest that colonoscopy with the original Endocuff or newer Endocuff Vision (EV) is superior to standard colonoscopy but that Endocuff has a greater impact than EV. However, the devices have not been compared head-to-head, and currently, only the EV is available. In a randomized controlled trial, colonoscopy with EV was compared to standard colonoscopy, with adenoma detection rates as the primary outcome, in patients with positive fecal immunochemical test results.

Douglas K. Rex, MD, MASGE reviewing Duvvuri A, et al. Gastroenterology 2021 Jan 28.

Postpolypectomy surveillance recommendations are based on observational studies, often using advanced adenomas at follow-up as their primary outcome. A new meta-analysis compared incident cancer and related mortality rates among 510,019 patients with low-risk, high-risk, or no adenomas detected at index colonoscopy.

Douglas K. Rex, MD, MASGE reviewing Pilonis ND, et al. Gastroenterology 2020 Dec 8.

Many guideline groups endorse offering patients multiple options for colorectal cancer screening, but randomized trials have shown that overall adherence is as high with sequential offers as multiple options, and more patients undergo colonoscopy (or another test offered first) with sequential offers. In this trial comparing participation outcomes, 12,485 patients were randomized to colonoscopy only, a sequential offer of colonoscopy and then fecal immunochemical testing (FIT), or the choice between colonoscopy and FIT.

Douglas K. Rex, MD, MASGE reviewing Mutneja HR, et al. J Gastroenterol Hepatol 2020 Dec 22.

Various guideline groups have recommended that patients with positive fecal immunochemical tests (FIT) undergo colonoscopy within 1 or 2 months. This study aimed to determine whether the timing of a colonoscopy after a positive FIT affects colorectal cancer detection outcomes.

Douglas K. Rex, MD, MASGE reviewing Di Palma JA, et al. Am J Gastroenterol 2020 Nov 6.

This study compared the safety and efficacy of a new formulation of oral sulfate in tablet form to polyethylene glycol with ascorbate. Oral sulfate tablets were recently approved for release in the U.S. The product launch is expected by January 2021.

Douglas K. Rex, MD, MASGE reviewing Sánchez A, et al. Clin Gastroenterol Hepatol 2020 Nov 2.

In the U.S., colonoscopy is usually performed at 1- to 2-year intervals in Lynch syndrome. This multicenter study, which included 893 Lynch syndrome carriers undergoing surveillance colonoscopy, evaluated the relationship of adenoma detection and postcolonoscopy colorectal cancer to quality indicators.