The impact of Endocuff-assisted colonoscopy on adenoma detection in an organized screening program

Background and study aims: Colorectal cancer (CRC) screening with biennial fecal occult blood test has been shown to reduce CRC mortality. For the effectiveness of the CRC screening program is crucial that a high-quality colonoscopy with a high adenoma detection rate (ADR) be performed. To improve ADR, various endoscopic devices have been developed. Endocuff, an endoscopic cap with finger-like projections, has been shown to improve ADR. The aim of this study was to compare in an organized CRC screening program ADR, advanced adenoma detection rate (AADR) and mean number of adenomas per patient (MAP) using standard colonoscopy (SC) and Endocuff-assisted colonoscopy (EAC). Patients and methods: We compared performance of SC (in 2014) and EAC (in 2015) in consecutive participants in an organized CRC screening program. Results: SC and EAC were performed in 546 (284 males) and 519 (293 males) subjects, respectively (mean age 60 years). Cecal intubation rate was 97.4 % for SC and 97.1 % for EAC and not significantly different ( P  = 0.7). ADR was 47 % for SC and 52 % for EAC, P  = 0.1. MAP in SC and EAC were 0.87 (range: 0 - 7) and 1.11 (range: 0 - 13) respectively, P  = 0.02. AADR rate was 25 % and 23 % for SC and EAC, respectively, P  = 0.5. Conclusion: Endocuff-assisted colonoscopy does not improve the number of patients with at least one adenoma but it may increase the number of detected adenomas per procedure.