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Standards of diagnostic colonoscopy for early-stage neoplasia: Recommendations by an Asian private group

Sano Y 1 , Chiu HM 2 , Li XB 3 , Khomvilai S 4 , Pisespongsa P 5 , Co JT 6 Show all authors , Kawamura T 7 , Kobayashi N 8 , Tanaka S 9 , Hewett DG 10 , Takeuchi Y 11 , Imai K 12 , Utsumi T 13 , Teramoto A 1 , Hirata D 1 , Iwatate M 1 , Singh R 14 , Ng SC 15 , Ho SH 16 , Chiu P 17 , Tajiri H 18

Affiliations 

  • 1 Gastrointestinal Center and Institute of Minimally invasive Endoscopic Care (iMEC), Sano Hospital, Hyogo
  • 2 Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
  • 3 Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Renji Hospital, School of Medicine, Shanghai Institute of Digestive Disease, Shanghai Jiao Tong University, Shanghai, China
  • 4 Surgical Endoscopy, Colorectal Surgery, Department of Surgery, Chulalongkorn University, Bangkok, Thailand
  • 5 Digestive Disease Center, Bumrungrad International Hospital, Bangkok, Thailand
  • 6 St. Luke's Medical Centre - Global City, Taguig City, Metro Manila, Philippines
  • 7 Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan
  • 8 Department of Gastroenterology, Tochigi Cancer Center, Tochigi, Japan
  • 9 Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
  • 10 Faculty of Medicine, University of Queensland, Brisbane, Australia
  • 11 Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
  • 12 Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
  • 13 Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
  • 14 Gastroenterology Unit, Division of Medicine, Lyell McEwin Hospital, School of Medicine, The University of Adelaide, Adelaide, Australia
  • 15 Departments of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, LKS Institute of Health Science, The Chinese University of Hong Kong, Hong Kong, China
  • 16 Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 17 Surgery, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, LKS Institute of Health Science, The Chinese University of Hong Kong, Hong Kong, China
  • 18 Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo, Japan
Dig Endosc, 2019 May;31(3):227-244.
PMID: 30589103 DOI: 10.1111/den.13330

Abstract

BACKGROUND AND AIM: In recent years, the incidence of colorectal cancer has been increasing, and it is now becoming the major cause of cancer death in Asian countries. The aim of the present study was to develop Asian expert-based consensus to standardize the preparation, detection and characterization for the diagnosis of early-stage colorectal neoplasia.

METHODS: A professional group was formed by 36 experts of the Asian Novel Bio-Imaging and Intervention Group (ANBI2 G) members. Representatives from 12 Asia-Pacific countries participated in the meeting. The group organized three consensus meetings focusing on diagnostic endoscopy for gastrointestinal neoplasia. The Delphi method was used to develop the consensus statements.

RESULTS: Through the three consensus meetings with debating, reviewing the literature and regional data, a consensus was reached at third meeting in 2016. The consensus was reached on a total of 10 statements. Summary of statements is as follows: (i) Adequate bowel preparation for high-quality colonoscopy; (ii) Antispasmodic agents for lesion detection; (iii) Image-enhanced endoscopy (IEE) for polyp detection; (iv) Adenoma detection rate for quality indicators; (v) Good documentation of colonoscopy findings; (vi) Complication rates; (vii) Cecal intubation rate; (viii) Cap-assisted colonoscopy (CAC) for polyp detection; (ix) Macroscopic classification using indigocarmine spray for characterization of colorectal lesions; and (x) IEE and/or magnifying endoscopy for prediction of histology.

CONCLUSION: This consensus provides guidance for carrying out endoscopic diagnosis and characterization for early-stage colorectal neoplasia based on the evidence. This will enhance the quality of endoscopic diagnosis and improve detection of early-stage colorectal neoplasia.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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