Original articleClinical endoscopyEndoscopic cuff–assisted colonoscopy versus cap-assisted colonoscopy in adenoma detection: randomized tandem study—DEtection in Tandem Endocuff Cap Trial (DETECT)
Section snippets
Study design
A prospective, randomized, tandem study was conducted between April 2016 and May 2017 in a single endoscopy unit in the United Kingdom. The DEtection in Tandem Endocuff Cap Trial (DETECT) protocol was reviewed and approved by the East of England (Cambridge) ethics committee on the January 4, 2016 (Reference 15/EE/0415). The study was registered with clinical trial.gov (NCT03254498) and International Standard Randomized Controlled Trials (ISRCTN 58994883).
Participants
Patients older than 18 years and
Results
Three hundred eighteen patients were invited to participate in the study. One hundred sixty-four patients were excluded because they either did not meet the inclusion criteria (55%) or declined to undergo tandem colonoscopies on the same day (39%). We recruited 154 patients (mean age, 61.3± 13.6 years) with equal sex distribution (men, 51%), and the trial flow chart is shown in Figure 5. Main indications for a colonoscopy were adenoma surveillance (28%), recent change in bowel habits (21%),
Discussion
This is the first tandem, crossover, randomized trial to compare EAC with CAC. The primary aim was to compare ADR, and our results highlighted that EAC significantly improved detection of adenomas by 27% compared with CAC (P = .001). The total number of polyps detected by EAC was significantly higher than that detected by CAC (153 vs 58, P < .001). Furthermore, EAC improved the detection of missed adenomas by 13% (EAC, 6%; CAC, 19%) and SSAs/Ps by 3% compared with CAC. Our findings were
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DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: R. Rameshshanker: Consultant for Aquilant Pvt Ltd, UK, and Norgine Ltd, UK. Z. Tsiamoulos: Consultant for Olympus Pvt Ltd, UK, Norgine Ltd, UK, Creo Medical Ltd, UK, Pentax Medical UK, and ARC Design UK. B.P. Saunders: Consultant for Norgine Ltd, Olympus Medical Ltd, UK, Creo Medical Ltd, UK, Boston Scientific, and Diagmed Ltd. All other authors disclosed no financial relationships.
If you would like to chat with an author of this article, you may contact Dr Rameshshanker at [email protected].