Rabago LR, Delgado Galan M. Precision in detecting colon lesions: A key to effective screening policy but will it improve overall outcomes? World J Gastrointest Endosc 2024; 16(3): 102-107 [PMID: 38577643 DOI: 10.4253/wjge.v16.i3.102]
Corresponding Author of This Article
Luis Ramon Rabago, Doctor, PhD, Chief, Former Contract Professor, Medical Assistant, Staff Physician, Department of Gastroenterology, Hospital San Rafael, Street Serrano 199, Madrid 28016, Spain. lrabagot@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Author contributions: Both authors have revised the issue, bibliography, and made editorial contributions to the manuscript.
Conflict-of-interest statement: We do not have any conflict-of-interest at all.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Luis Ramon Rabago, Doctor, PhD, Chief, Former Contract Professor, Medical Assistant, Staff Physician, Department of Gastroenterology, Hospital San Rafael, Street Serrano 199, Madrid 28016, Spain. lrabagot@gmail.com
Received: December 15, 2023 Peer-review started: December 15, 2023 First decision: December 23, 2023 Revised: December 29, 2023 Accepted: January 23, 2024 Article in press: January 23, 2024 Published online: March 16, 2024
Abstract
Colonoscopy is the gold standard for the screening and diagnosis of colorectal cancer, resulting in a decrease in the incidence and mortality of colon cancer. However, it has a 21% rate of missed polyps. Several strategies have been devised to increase polyp detection rates and improve their characterization and delimitation. These include chromoendoscopy (CE), the use of other devices such as Endo cuffs, and major advances in endoscopic equipment [high definition, magnification, narrow band imaging, i-scan, flexible spectral imaging color enhancement, texture and color enhancement imaging (TXI), etc.]. In the retrospective study by Hiramatsu et al, they compared white-light imaging with CE, TXI, and CE + TXI to determine which of these strategies allows for better definition and delimitation of polyps. They concluded that employing CE associated with TXI stands out as the most effective method to utilize. It remains to be demonstrated whether these results are extrapolatable to other types of virtual CE. Additionally, further investigation is needed in order to ascertain whether this strategy could lead to a reduction in the recurrence of excised lesions and potentially lower the occurrence of interval cancer.
Core Tip: The endoscope's texture and color enhancement imaging mode, combined with chromoendoscopy, has demonstrated improvements in the characterization of mucosal colonic lesions, providing better visualization of their borders and lesion surfaces. However, its real impact on lesion recurrence and rates of interval cancers is yet to be proven through more prospective studies.
