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ASGE Journal Scan | Colon

Risks of Recurrence and Mortality After Local Endoscopic Resection of T1 Colorectal Cancer

In a meta-analysis of 71 studies involving 5167 endoscopically treated T1 colorectal cancers (CRCs), the cumulative recurrence rate was 3.3%, the local recurrence rate was

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ASGE Journal Scan | Colon

Yes, Early Onset Colorectal Adenocarcinoma Rates Are Increasing, But Rectal Carcinoid Rates Are Increasing Faster

There is now widespread recognition that there are increasing rates of colorectal cancer in persons under age 50 (early-onset colorectal cancer), that most of the

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ASGE Journal Scan | Colon

Depressed Lesions Are Different at a Histologic and Molecular Level

In a study from Japan, T1 colorectal cancers and adenomas were classified as “depressed,” “flat,” or “protruded” subtypes. Depressed lesions constituted only 1.2% of all

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ASGE Journal Scan | Colon

Predicting Complete Closure of EMR Sites

Clip closure of endoscopic mucosal resection (EMR) defects ≥20 mm located proximal to the splenic flexure and removed by electrocautery is associated with a reduction

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ASGE Journal Scan | Colon

Patients With Multifocal Cancer: Evidence for Intraluminal Spread of Tumor

In various series, 2% to 7% of patients with colorectal cancer (CRC) have either synchronous or metachronous second cancer. Second CRCs have generally been considered

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ASGE Journal Scan | Colon

Hot Snare Polypectomy of 5-9 mm Polyps Leads To More Next-Day Abdominal Pain

Cold snare polypectomy is widely considered to be comparably effective and safer than hot snare polypectomy for colorectal polyps <10 mm. In a randomized trial

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ASGE Journal Scan | Colon

New Expert Review From the American Gastroenterological Association on Managing Colonic Diverticulitis

The American Gastroenterological Association has issued a clinical practice update on the management of colonic diverticulitis. The recommendations are as follows: Physicians should order a

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ASGE Journal Scan | Colon

Positive Incidental Colorectal PET/CT: Sometimes Serious Lesions, Sometimes Not

There is general agreement that when positron emission tomography (PET) incidentally lights up the colon, there is a substantial positive predictive value for cancer and

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ASGE Journal Scan | Colon

Appendicitis Treatments: Large Randomized Controlled Trial Compares Antibiotics With Appendectomy

Antibiotic treatment is now widely recognized as an option for appendicitis therapy. In a nonblinded randomized trial of 1552 adults, including 414 with an appendicolith,

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ASGE Journal Scan | Colon

When Is Clip Closure of EMR Defects Cost-Effective?

Randomized controlled trials demonstrate that prophylactic clip closure of endoscopic mucosal resection (EMR) defects of large (≥20 mm) nonpedunculated colorectal lesions effectively prevents delayed hemorrhage.

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ASGE Journal Scan | Colon

Multi-Society Task Force Issues Malignant Polyp Management Recommendations

The U.S. Multi-Society Task Force on Colorectal Cancer, which consists of experts from the 3 luminal GI societies, has issued recommendations on the management of

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ASGE Journal Scan | Colon

Oral Sulfate Tablets for Bowel Preparation Are Effective and Safe

This study compared a new formulation of oral sulfate in tablet form to polyethylene glycol with ascorbate (PEG-EA). Both types of preparation were given in

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ASGE Journal Scan | Colon

Non-White Race and Low Socioeconomic Status Associated With Longer Wait for Treatment After Colorectal Cancer Diagnosis

The time between diagnosis of colorectal cancer (CRC) and initiation of treatment is associated with mortality. In this study of 330,988 CRC cases in the

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ASGE Journal Scan | Colon

Sessile Serrated Lesions That Are 10 mm or Larger: No Need To Inject

Cold resection of sessile serrated lesions (SSLs) ≥10 mm in size is increasingly accepted as effective and, compared to electrocautery, is safer. Many experts prefer

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ASGE Journal Scan | Colon

Poor Compliance With Antithrombotic Guidelines Associated With Bad Outcomes

Rates of polypectomy in colonoscopy are high for all indications; therefore, clinicians usually stop antiplatelet and antithrombotic agents other than aspirin prior to colonoscopy and

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ASGE Journal Scan | Colon

Lynch Syndrome Colonoscopy: Quality Matters

In the U.S., colonoscopy is usually performed at 1- to 2-year intervals in Lynch syndrome. This multicenter study evaluated the relationship of adenoma detection and

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ASGE Journal Scan | Colon

Colonoscopy Performance Produces Force Levels and Durations of Force Elevation That Are Associated With Upper Extremity Injury

Musculoskeletal injuries are common in endoscopists. This study used surface electromyography of wrist flexors and extensors as well as pressure transducers on the thumbs to

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ASGE Journal Scan | Colon

Colon Capsule Endoscopy Scorches CT Colonography in Fecal Immunochemical Test-Positive Trial

Comparative trials in patients with prior incomplete colonoscopy suggest that colon capsule endoscopy (CCE) detects polyps with higher sensitivity than CT colonography (CTC). In the

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ASGE Journal Scan | Colon

Postcolorectal Endoscopic Mucosal Resection Follow-up Is Essential

There is a well-known risk of adenoma recurrence after piecemeal endoscopic mucosal resection (EMR).  In a single-center study of 2411 nonpedunculated lesions ≥20 mm in

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ASGE Journal Scan | Colon

Polish Study Calls for Using Adenoma Detection Rate to Stratify Screening and Surveillance Recommendations

In this study, the risk of interval cancer was compared between doctors with high (≥20%) versus low (<20%) adenoma detection rates (ADRs) in the Polish

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ASGE Journal Scan | Colon

Anesthesia and Pathology Charges Lead to Surprise Billing in Commercially Insured Colonoscopy

This study reviewed colonoscopies identified in a claims database from a large national insurer in the United States. The database was queried for commercially insured

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ASGE Journal Scan | Colon

Kaiser Achieved Greater Than 80% Screening Adherence; How Did They Do It?

Organized screening, in which a nation or health care system systematically offers colorectal cancer screening for eligible patients, usually by fecal immunochemical testing (FIT), is

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ASGE Journal Scan | Colon

Symptoms are Common After Total Proctocolectomy With Ileal Pouch Creation in Patients With Familial Adenomatous Polyposis

Pouch symptoms are typically considered to occur less frequently after total proctocolectomy and ileal pouch-anal anastomosis (IPAA) for familial adenomatous polyposis (FAP) compared to after

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ASGE Journal Scan | Colon

New Clinical Model Predicts Need for Screening Colonoscopy

A risk-stratified approach to colorectal cancer screening within the average-risk population is seldom used. In this approach, patients whose prescreening predicted prevalence of advanced neoplasia

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ASGE Journal Scan | Colon

Which Rectal Neuroendocrine Tumors are Dangerous?

In this study of 309 rectal neuroendocrine tumors (NETs), often called rectal carcinoids in the past, endoscopic factors were studied to understand their association with

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ASGE Journal Scan | Colon

Negative Colonoscopy for FIT-Positive Patients: Should We Keep Doing FIT?

In this study from Taiwan, patients with a negative colonoscopy after a positive fecal immunochemical test (FIT) during the interval 2004 through 2009 were followed

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ASGE Journal Scan | Colon

Chemoprevention for Colorectal Cancer: What Works and What Doesn’t?

This was a systematic review of 80 meta-analyses of colorectal cancer prevention with medications, vitamins, supplements, and dietary factors.  Of the factors found to be

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ASGE Journal Scan | Colon

Even Expert Pathologists Have Only Moderate Agreement Regarding Differentiating Sessile Serrated Lesions From Hyperplastic Polyps

Current recommendations for measurement of the adenoma detection rate (ADR) recommend that sessile serrated lesions (SSLs; also called sessile serrated adenomas and sessile serrated polyps)

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ASGE Journal Scan | Colon

Artificial Intelligence System Outperforms Guideline Predictive Criteria for Lymph Node Metastasis in T1 Cancers

In a study from 7 centers in Japan, a deep learning artificial intelligence (AI) program trained on 3134 T1 colorectal cancers (CRCs) from 6 Japanese

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ASGE Journal Scan | Colon

ESGE Issues Comprehensive Training Curriculum on Optical Diagnosis

The extent to which optical diagnosis is used in routine endoscopy in the United States to improve treatment decisions in endoscopy is virtually unknown.  The

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ASGE Journal Scan | Colon

More Evidence That Negative Screening Colonoscopy Can Be Followed by Intervals of More Than 10 Years

This study compared the incidence of advanced neoplasms in 2456 German screening colonoscopy patients who had a previous colonoscopy without polyps to the results from

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ASGE Journal Scan | Colon

Computerized Imaging of Vessels in EMR Defects Predicts Postprocedural Bleeding

Recent studies indicate that prophylactic clip closure of postendoscopic mucosal resection defects from colonic lesions >20 mm in size and proximal to the splenic flexure

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ASGE Journal Scan | Colon

Monoallelic NTHL1 Loss of Function Not Associated With Colorectal Cancer

NTHL1 encodes endonuclease III-like protein 1, an enzyme involved in base-excision repair that identifies and removes oxidized pyrimidines. Biallelic loss-of-function mutations of base-excision repair genes, such

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ASGE Journal Scan | Colon

Optical Character Recognition Combined With Natural Language Processing to Improve Extraction of Quality Parameters From Colonoscopy Reports

Measurement and improvement of colonoscopy quality measures, such as the adenoma detection rate (ADR), are critical to optimizing colorectal cancer prevention by colonoscopy. The process

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ASGE Journal Scan | Colon

Most Primary Care Physicians Not Following the American Cancer Society’s Recommendation to Screen at Age 45

The American Cancer Society (ACS) recommended in 2018 that all Americans should undergo colorectal cancer (CRC) screening beginning at age 45. Thus far, other major

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ASGE Journal Scan | Colon

American Gastroenterological Association Issues Guidelines on GI Evaluation of Iron Deficiency Anemia

The American Gastroenterological Association (AGA) has issued the following recommendations regarding GI evaluation of iron deficiency anemia (IDA): In patients with anemia, IDA should be

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ASGE Journal Scan | Colon

What Are Cold Snare Protrusions and Are They a Bad Thing?

During cold snare polypectomy, removal of larger lesions and/or larger specimens sometimes results in a cold snare protrusion (CSP), appearing as a white cord in

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ASGE Journal Scan | Colon

Hemostasis Peptide Reduces Need for Electrocoagulation of Bleeding Points During ESD

Bleeding is common during endoscopic submucosal dissection (ESD). It can obscure dissection planes and often requires electrocoagulation that could injure the muscularis propria. PuraStat (3D-Matrix,

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ASGE Journal Scan | Colon

Risk of Death From Colonoscopy in the Italian FIT Screening Program

Organized fecal immunochemical test (FIT)-based screening programs offer the opportunity to prospectively assess adverse events of colonoscopy. A recent large study from the Netherlands found

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ASGE Journal Scan | Colon

All That Time That Cannot Be Billed

Previous data found that primary care physicians and some specialists spend about an hour on electronic health records (EHRs) for each hour they are scheduled

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ASGE Journal Scan | Colon

Risk of Death From Colonoscopy in a FIT-Positive Program

In any screening program, it is important to know the benefits and harms of screening. Patients who have a positive fecal immunochemical test (FIT) result

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ASGE Journal Scan | Colon

Early Colorectal Cancer Screening in African Americans: High Uptake and High Yield

Recommendations from GI societies to screen African Americans for colorectal cancer (CRC) starting at age 45 were based largely on age-related incidence and mortality data

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ASGE Journal Scan | Colon

Granular Laterally Spreading Tumors With Nodule: Rectal Location and at Least 4-cm Size Warrant en Bloc Resection

Granular laterally spreading tumors (G-LST) in the colorectum are more common than nongranular lesions, less likely to have cancer, and in general, easier to remove

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ASGE Journal Scan | Colon

Acetic Acid and Blue Light Highlight Sessile Serrated Lesions

This case study demonstrates how acetic acid in combination with blue-light imaging (BLI), a relatively new mode of chromoendoscopy technology, highlights sessile serrated lesions (SSLs).

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ASGE Journal Scan | Colon

Delayed Start Times Associated With Reduced Adenoma Detection

Previous studies have shown that the adenoma detection rate (ADR) is sometimes lower in colonoscopies performed in the afternoon versus the morning, though the results

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ASGE Journal Scan | Colon

Surgery Not Needed After Complete Endoscopic Resection of Intramucosal Colorectal Cancer

Intramucosal cancer (IMC) refers to dysplasia in the lamina propria of the mucosa with or without invasion of the muscularis mucosa. Such lesions are usually

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ASGE Journal Scan | Colon

Initial Experience With EndoRotor Tissue Resection Device

The EndoRotor nonthermal powered endoscopic debridement (PED) instrument (Interscope, Inc., Whitinsville, Mass) is a new tissue resection device that can be passed through endoscopes. There

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ASGE Journal Scan | Colon

ESGE Expands the Postpolypectomy Cohort With No Recommended Surveillance

The European Society of Gastrointestinal Endoscopy (ESGE) has issued its first update of postpolypectomy surveillance recommendations since 2013. Key recommendations include the following: Patients with

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ASGE Journal Scan | Colon

Adding Time for Inspection During Colonoscope Insertion Does Not Work

There remain occasional advocates of dedicated time during colonoscope insertion to look for polyps as a way of increasing detection. In this analysis of 7

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ASGE Journal Scan | Colon

Prophylactic Clipping Ineffective for Polyps Less Than 20 mm in Size

Analyses of randomized trials indicate that prophylactic clipping of EMR sites ≥20 mm in size in the proximal colon reduces the risk of delayed hemorrhage.

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ASGE Journal Scan | Colon

Dutch Endoscopic Full-Thickness Resection Experience in Colorectum

This report summarizes a prospectively acquired experience using the endoscopic full-thickness resection device (FTRD) in the colorectum. Among 367 procedures performed between July 2015 and

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ASGE Journal Scan | Colon

Adenomas in the Young: What Do They Mean?

The incidence of colorectal cancer (CRC) is increasing in persons under age 50 in much of the world. Endoscopists commonly encounter sporadic adenomas when performing

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ASGE Journal Scan | Colon

Sarcopenia (Loss of Skeletal Muscle Mass) Associated With Metachronous Adenomas

Sarcopenia is a progressive loss of skeletal muscle mass in relation to aging. Sarcopenia is associated with metabolic syndrome, diabetes, and nonalcoholic steatohepatitis and has

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ASGE Journal Scan | Colon

Negative Colonoscopy Predicts Reduced Risk of Colon Cancer for 17 Years

Previous studies in symptomatic populations have found that a negative colonoscopy predicts a reduction in colorectal cancer (CRC) incidence for greater than 20 years. The

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ASGE Journal Scan | Colon

Malpractice Trends in Colon Cancer

This study identified 240 malpractice cases related to colorectal cancer (CRC) between 1988 and 2018 by using a legal database called VerdictSearch. This database is

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ASGE Journal Scan | Colon

Randomized Controlled Trial of Fellow Impact on Detection

There is widespread acceptance of a second-observer effect in improving adenoma detection in colonoscopy and general acceptance that this effect extends, in some regard, to

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ASGE Journal Scan | Colon

Lynch Syndrome Testing on Preoperative Biopsy Specimens Is Accurate

In this study, there were 96 patients with matched preoperative and postoperative immunohistochemistry (IHC) and microsatellite instability testing results for Lynch syndrome. The concordance of

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ASGE Journal Scan | Colon

No Correlation Between Detection and Optical Diagnosis in Colon Polyps

This is a Dutch multicenter study involving 24 colonoscopists who performed at least 50 colonoscopies in a fecal immunochemical test-positive population. All were high-performing colonoscopists

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ASGE Journal Scan | Colon

Artificial Intelligence Program Increases Adenoma Detection Rate in Randomized Controlled Trial by 14%

In a randomized controlled trial conducted at 3 Italian centers with 6 experienced endoscopists and 685 patients with a mix of screening, surveillance, and fecal

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ASGE Journal Scan | Colon

Meta-analysis Favors Low-Residue Diet Before Colonoscopy

This meta-analysis comparing a low-residue diet to a clear liquid diet the day before colonoscopy identified 20 relevant randomized controlled trials that were published between

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ASGE Journal Scan | Colon

Collagenous Colitis Is a Genetic Disease

Collagenous colitis (CC) produces a watery diarrhea syndrome, occurs mostly in older women, and is associated with several drug classes. Recent studies show that patients

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ASGE Journal Scan | Colon

Predicting CRC in Unscreened Populations by CBC

About one-third of the U.S. population is unscreened for colorectal cancer (CRC). One approach to early detection in this population is to screen health care

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ASGE Journal Scan | Colon

Some GI Doctors May Not Understand Significance of Intramucosal Adenocarcinoma in the Colon

Several studies have found that rates of surgery for benign colorectal polyps continue to be high, despite clear evidence that endoscopic resection is safer and

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ASGE Journal Scan | Colon

Meta-analysis for 6- to 9-mm Adenomas Shows Higher Risk of Subsequent Advanced Neoplasia Compared to 1 to 5 mm

Current surveillance recommendations classify patients with 1 or 2 tubular adenomas <10 mm in size and with low-grade dysplasia as low risk. Several studies have

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ASGE Journal Scan | Colon

Randomized Colorectal Cancer Screening Trial Includes Risk-Stratified Arm

Colorectal cancer (CRC) screening can be offered to patients as a menu of screening options; sequential testing (colonoscopy offered first with another testing option offered

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ASGE Journal Scan | Colon

Evidence for Routine Double Right-Sided Colon Examination

Double right-sided colon examination during colonoscopy is often recommended, and randomized controlled trials have compared a second examination of the right-sided colon in the forward

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ASGE Journal Scan | Colon

Risks of Colonoscopy: Not Just Bleeding and Perforation

This French study evaluated 4,088,799 patients undergoing a first-time colonoscopy during a 6-year interval. Patients with inflammatory bowel disease, colorectal cancer, or complicated diverticular disease

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ASGE Journal Scan | Colon

Quantitative Assignment of Ages to Start Screening Based on Family History

In a study from Sweden involving 12,829,251 persons who had family history information and were followed from 1958 to 2015, 173,796 developed colorectal cancer (CRC).

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ASGE Journal Scan | Colon

No Benefit of Endocuff Vision in Screening Flexible Sigmoidoscopy

Endocuff Vision (EV) has well-established benefits in colonoscopy, both for improved detection and faster withdrawal without reduced detection.  EV has not been tested for its

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ASGE Journal Scan | Colon

High-Volume Colonoscopy Predicts Higher Cecal Intubation Rates and Lower Perforation Risk, but Not Higher Detection or Cancer Prevention

Douglas K. Rex, MD, FASGE, reviewing Forbes N, et al. Clin Gastroenterol Hepatol 2020 Mar 20. In a systematic review and meta-analysis encompassing 27 studies

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ASGE Journal Scan | Colon

Endocuff Vision Improves Detection in High Performers

In meta-analyses, Endocuff Vision (ECV) typically increases adenoma detection rates (ADRs) by about 7%. However, one meta-analysis found that the benefit was primarily in doctors

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ASGE Journal Scan | Colon

Smartphone App for Bowel Prep Reduced Inadequate Preps and Improved ADR

Douglas K. Rex, MD, FASGE, reviewing Walter B, et al. Clin Gastroenterol Hepatol 2020 Mar 30. A variety of apps to assist in bowel preparation

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ASGE Journal Scan | Colon

Pocket Method Beats Conventional Colorectal Endoscopic Submucosal Dissection in Randomized Controlled Trial

Douglas K. Rex, MD, FASGE, reviewing Yamashina T, et al. Gastrointest Endosc 2020 Feb 28. The conventional method (CM) of endoscopic submucosal dissection (ESD) involves

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ASGE Journal Scan | Colon

Microprocessor-Controlled Endo Cut Versus Forced Coagulation: No Difference in Delayed Hemorrhage

Douglas K. Rex, MD, FASGE, reviewing Pohl H, et al. Gastroenterology 2020 Mar 12. Previous uncontrolled studies indicated that forced-coagulation (FC) current (the blue pedal)

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ASGE Journal Scan | Colon

Molecular Markers Predict Prognosis in Colorectal Cancer

Douglas K. Rex, MD, FASGE, reviewing Phipps AI, et al. Gastroenterology 2020 Feb 20. Current recommendations from the U.S. Multi-Society Task Force recommend that all

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ASGE Journal Scan | Colon

Two From the Ascending Colon and Two From the Descending Colon: Biopsies From Microscopic Colitis Simplified

Douglas K. Rex, MD, FASGE, reviewing Virine, B, et al. Clin Gastroenterol Hepatol 2020 Feb 25. Guidelines recommend that clinicians perform 8 biopsies total from

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ASGE Journal Scan | Colon

Deciding on Surgery After Endoscopic Resection of T1-CRC? Repeat Colonoscopy and Biopsy Do Not Help

Douglas K. Rex, MD, FASGE, reviewing Gijsbers KM, et al. Gastrointest Endosc 2020 Feb 24. In general, when a flat or sessile T1 colorectal cancer

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ASGE Journal Scan | Colon

Primary Care Physicians Order 88% of FIT-Fecal DNA Tests

Douglas K. Rex, MD, FASGE, reviewing Weiser E, et al. J Med Screen 2020 Feb 13. This industry-sponsored study examined adherence rates to the fecal

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ASGE Journal Scan | Colon

Improving ADR Shown Again to Save Lives

Douglas K. Rex, MD, FASGE, reviewing Lam AY, et al. Gastrointest Endosc 2020 Feb 21. A 2017 study from the Polish screening colonoscopy program showed

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ASGE Journal Scan | Colon

Radiographic Studies Unreliable for Polyp Detection in Patients With Incomplete Colonoscopy

Douglas K. Rex, MD, FASGE, reviewing Parsa N, et al. Gastrointest Endosc 2020 Feb 4. In a single U.S. center with a large experience performing

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ASGE Journal Scan | Colon

Meta-analysis Associates Helicobacter pylori Infection With Colorectal Neoplasia

Douglas K. Rex, MD, FASGE, reviewing Choi DS, et al. Clin Transl Gastroenterol 2020 Feb. Helicobacter pylori (H. pylori) infection has been previously associated with colorectal

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ASGE Journal Scan | Colon

Calculating Effect of Surveillance Colonoscopy on Colon Cancer Prevention

he U.S. Multi-Society Task Force on Colorectal Cancer recently presented new postpolypectomy surveillance recommendations. Perhaps the most impactful new recommendation is that patients with 1

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ASGE Journal Scan | Colon

New Evidence Supports Surveillance Colonoscopy for Patients With Stage I Colon Cancer

Gastroenterologists may be surprised to learn that some guideline groups do not endorse surveillance colonoscopy after resection of stage I colon cancer because of a

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ASGE Journal Scan | Colon

Vitamin D Supplementation Did Not Prevent Adenomas or Serrated Lesions

Douglas K. Rex, MD, FASGE, reviewing Song M, et al. Clin Gastroenterol Hepatol 2020 Feb 13. There is an association between vitamin D levels and

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ASGE Journal Scan | Colon

Updated Postpolypectomy Surveillance Recommendations of the Multi-Society Task Force

Douglas K. Rex, MD, FASGE, reviewing Gupta S, et al. Gastroenterology 2020 Feb 7. The U.S. Multi-Society Task Force on Colorectal Cancer has updated its

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ASGE Journal Scan | Colon

Considering Endoscopy in Iron Deficiency Anemia? Don’t Rely on Fecal Blood Testing to Decide

Douglas K. Rex, MD, FASGE, reviewing Lee MW, et al. Am J Gastroenterol 2020 Jan 10. Fecal blood testing is approved as a colorectal cancer

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ASGE Journal Scan | Colon

Berberine Reduces Metachronous Colorectal Adenomas in Randomized Trial

Douglas K. Rex, MD, FASGE, reviewing Chen YX, et al. Lancet Gastroenterol Hepatol 2020 Jan 8. Berberine is a Chinese herbal extract used to treat

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ASGE Journal Scan | Colon

Improving the Message of Mailed Outreach Improves CRC Screening Adherence

Douglas K. Rex, MD, FASGE, reviewing Bakr O, et al. Clin Transl Gastroenterol 2020 Jan. Mailed outreach, in which a fecal immunochemical test (FIT) kit

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ASGE Journal Scan | Colon

Expanding Cold EMR to Large Laterally Spreading Lesions

Douglas K. Rex, MD, FASGE, reviewing Mangira D, et al. Gastrointest Endosc 2020 Jan 15. In 5 Australian academic hospitals, cold EMR was performed on

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ASGE Journal Scan | Colon

High Definition Is Still the Only Way to Go

Douglas K. Rex, MD, FASGE, reviewing Tziatzios G, et al. Gastrointest Endosc 2020 Jan 15. Previous meta-analyses have suggested that the use of high-definition (HD)

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ASGE Journal Scan | Colon

Artificial Intelligence for the Other Half of Detection at Colonoscopy

Douglas K. Rex, MD, FASGE, reviewing Thakkar S, et al. Gastroenterology 2020 Jan 13. Assuming that a colonoscopist knows what precancerous lesions look like, high-level

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ASGE Journal Scan | Colon

Cancer After Colonoscopy in UK Study Associated With, Well, Some Very Poor-Quality Colonoscopy

Douglas K. Rex, MD, FASGE, reviewing Anderson R, et al. Gastroenterology 2020 Jan 8.  Interval cancer, or postcolonoscopy cancer, is one of the dreaded outcomes

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ASGE Journal Scan | Colon

End-Stage Renal Disease Still Risk Factor for Colonoscopy Complications

Douglas K. Rex, MD, FASGE, reviewing Yang SC, et al. J Gastroenterol Hepatol 2020 Jan 3. End-stage renal disease (ESRD) has been considered a risk

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ASGE Journal Scan | Colon

For Left-Sided Colon Lesions up to 25 mm and Right-Sided Colon Lesions up to 20 mm, Piecemeal EMR Is as Good as en Bloc Resection

Douglas K. Rex, MD, FASGE reviewing Tate DJ, et al. Gastrointest Endosc 2019 Dec 27. Advanced endoscopists are often tempted to remove laterally spreading lesions

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ASGE Journal Scan | Colon

Observations on FIT-Fecal DNA Testing in Clinical Practice

Douglas K. Rex, MD, FASGE reviewing Vakil N, et al. Gastrointest Endosc 2020 Jan 2. The commercially available FIT (fecal immunochemical test)-fecal DNA test is

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ASGE Journal Scan | Colon

Small Left-Sided Polyps Seen During Colonoscope Insertion: Remove Them When You See Them

Douglas K. Rex, MD, FASGE reviewing Teramoto A, et al. Gastrointest Endosc 2019 Dec 23. Experienced colonoscopists know that when a small polyp is encountered

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ASGE Journal Scan | Colon

How Do We Get to 80% Screening?

Douglas K. Rex, MD, FASGE reviewing Inadomi JM, et al. Clin Gastroenterol Hepatol 2019 Dec 27. The National Colorectal Cancer Roundtable set a goal of

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ASGE Journal Scan | Colon

Brits Shake Up Postpolypectomy Surveillance

Douglas K. Rex, MD, FASGE reviewing Rutter MD, et al. Gut 2019 Nov 27. British societies have always had their own postpolypectomy guidelines. Previous recommendations

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ASGE Journal Scan | Colon

Review and Meta-analysis Finds FIT CRC Sensitivity Lower in Stage I and T1

Douglas K. Rex, MD, FASGE reviewing Niedermaier T, et al. Am J Gastroenterol 2019 Dec 10. Fecal immunochemical test (FIT) sensitivity for colorectal cancer (CRC)

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ASGE Journal Scan | Colon

Polygenic Risk Score Has Predictive Value for Early Onset Colorectal Cancer

Douglas K. Rex, MD, FASGE reviewing Archambault AN, et al. Gastroenterology 2019 Dec 19. Everyone wants to understand the underlying drivers for why early-onset colorectal

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ASGE Journal Scan | Colon

Not Asking Enough Questions: Low Rates of Recommending and Receiving Genetic Testing in U.S. in Those at Risk for Lynch Syndrome

Douglas K. Rex, MD, FASGE reviewing Faust N, et al. Gastroenterology 2019 Dec 6. The National Health Interview Survey is conducted every 5 years and

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ASGE Journal Scan | Colon

New ASGE Guideline on Endoscopy and Management of ACPO and Colonic Volvulus

Douglas K. Rex, MD, FASGE reviewing Naveed M, et al. Gastrointest Endosc 2019 Nov 29. Some of the key and/or interesting findings in the new

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ASGE Journal Scan | Colon

Endoscopic Resection Effective for SSPs ≥10 mm in Meta-analysis; Cold EMR May Be Best

Douglas K. Rex, MD, FASGE reviewing Chandrasekar VT, et al. Clin Gastroenterol Hepatol 2019 Nov 28. This systematic review and meta-analysis identified 911 patients with

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ASGE Journal Scan | Colon

Endocuff Vision Defeats Cap in Tandem Study

Douglas K. Rex, MD, FASGE reviewing Rameshshanker R, et al. Gastrointest Endosc 2019 Dec 10. Recent controlled trials comparing Endocuff Vision (EV) to cap-assisted colonoscopy

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ASGE Journal Scan | Colon

Colonoscopy in Inpatient Octogenarians: Beware

Douglas K. Rex, MD, FASGE reviewing Olaiya B, Adler DG. J Clin Gastroenterol 2019 Nov 22. Population-based studies have consistently shown that the risk of

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ASGE Journal Scan | Colon

Pay Attention to Anal Cancer

Douglas K. Rex, MD, FASGE reviewing Deshmukh AA, et al. J Natl Cancer Inst 2019 Nov 19. In the period 2001 to 2015, squamous cell

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ASGE Journal Scan | Colon

Endoscopic Mucosal Resection: First-Line Treatment for Laterally Spreading Lesions at Anorectal Junction

Douglas K. Rex, MD, FASGE reviewing Shahidi N, et al. Gut 2019 Nov 12. Laterally spreading lesions at the anorectal junction can be treated by

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ASGE Journal Scan | Colon

ESGE Endorses Resect and Discard in Routine Practice

Douglas K. Rex, MD, FASGE reviewing Bisschops R, et al. Endoscopy 2019 Nov 11. The European Society of Gastrointestinal Endoscopy (ESGE) has issued an updated

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ASGE Journal Scan | Colon

Another Study Supports Underwater Versus Conventional Endoscopic Mucosal Resection for Lesions ≥10 mm

Recent randomized controlled trials found that underwater endoscopic mucosal resection (UEMR) results in more en bloc resections and faster resection for flat and sessile colorectal

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ASGE Journal Scan | Colon

Randomized Trial of Sequential Testing Versus Multiple Choices for CRC Screening

Many guidelines on colorectal cancer (CRC) screening advocate that the choice of screening tests should be based on a discussion between the provider and patient

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ASGE Journal Scan | Colon

Ontario Physicians More Likely to Get Colonoscopy Than Their Patients

This study evaluated administrative health care data from Ontario, Canada, to determine colorectal cancer screening rates among physicians, aged 52 to 74 years, and their

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ASGE Journal Scan | Colon

Colon Capsule Doesn’t Help in FIT-Positive Patients

Douglas K. Rex, MD, FASGE reviewing Pecere S, et al. Gastrointest Endosc 2019 Oct 17. In some European countries with limited colonoscopy resources, capsule colonoscopy

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ASGE Journal Scan | Colon

Biennial Surveillance Is the Right Interval in Lynch

Douglas K. Rex, MD, FASGE reviewing Peterese EFP, et al. Clin Gastroenterol Hepatol 2019 Oct 17. Universal screening of colorectal cancers (CRCs) for Lynch syndrome

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ASGE Journal Scan | Colon

ACP Issues CRC Screening “Guidance Statement”; Declines to Endorse Either FIT-Fecal DNA or CT Colonography

Douglas K. Rex, MD, FASGE reviewing Qaseem A, et al. Ann Intern Med 2019 Nov 5. The American College of Physicians (ACP) has issued a

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ASGE Journal Scan | Colon

More on Bad Outcomes After Surgery for Benign Colon Polyps

Douglas K. Rex, MD, FASGE reviewing Ma C, et al. Am J Gastroenterol 2019 Oct 11.  Recent studies have established that surgery for benign colon

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ASGE Journal Scan | Colon

Seven Percent Are “One-and-Done” Colonoscopists

Douglas K. Rex, MD, FASGE reviewing Fedewa SA, et al. Endosc Int Open 2019 Nov. “One and done” in colonoscopy refers to endoscopists who find

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ASGE Journal Scan | Colon

Dual Antiplatelet Therapy Judged Safe for Cold Snare Polypectomy ≤10 mm

Douglas K. Rex, MD, FASGE reviewing Won D, et al. Clin Transl Gastroenterol 2019 Oct 10.  Patients on both aspirin and a second antiplatelet agent

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ASGE Journal Scan | Colon

Endocuff Vision Made Polypectomy Faster

Douglas K. Rex, MD, FASGE reviewing von Figura G, et al. Endoscopy 2019 Oct 15. Endocuff Vision (EV) has been shown in randomized controlled trials

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ASGE Journal Scan | Colon

Modeling Study Shows Current Surveillance Colonoscopy Paradigms Are Cost-Effective

Douglas K. Rex, MD, FASGE reviewing Meester RGS, et al. Ann Intern Med 2019 Sep 24. Some modeling studies suggest that surveillance colonoscopy in patients

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ASGE Journal Scan | Colon

Follow Pyogenic Liver Abscess With Colonoscopy

Douglas K. Rex, MD, FASGE reviewing Mohan BP, et al. Dig Liver Dis 2019 Oct 7.  Researchers examined results from 12 previous studies including a

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ASGE Journal Scan | Colon

Younger Physicians Are Better Detectors at Colonoscopy

Douglas K. Rex, MD, FASGE reviewing Shaukat A, et al. Clin Gastroenterol Hepatol 2019 Sep 10. A previous study showed that female endoscopists had higher

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ASGE Journal Scan | Colon

Meta-analysis Confirms Two Observers Better Than One for Polyp Detection

Douglas K. Rex, MD, FASGE reviewing Aziz M, et al. Clin Gastroenterol Hepatol 2019 Oct 4. Among 5 randomized controlled trials, 2 observers increased the

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ASGE Journal Scan | Colon

Cancer Incidence and Mortality in Adenoma Cohorts in Northern California Kaiser

Douglas K. Rex, MD, FASGE reviewing Lee JK, et al. Gastroenterology 2019 Oct 4. Databases developed from colonoscopies performed in the Kaiser Permanente Northern California

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ASGE Journal Scan | Colon

Large RCT Shows No Benefit of Early Colonoscopy in Patients With Acute LGIB

A benefit of early colonoscopy (in the first 24 hours) after hospitalization for acute lower-GI bleeding (LGIB) remains uncertain. In a large, randomized, controlled trial

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ASGE Journal Scan | Colon

One Positive FIT and One Negative? Still Do Colonoscopy

Most fecal immunochemical testing as a screen for colon cancer is done with one sample. However, patients with a positive test sometimes request a second

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ASGE Journal Scan | Colon

Acute Diverticulitis Still an Indication for Colonoscopy

Acute diverticulitis is generally considered an indication for colonoscopy, but the results of studies have been mixed with regard to the risk of colorectal cancer

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ASGE Journal Scan | Colon

6- to 9-mm Adenomas Again Shown to Predict Advanced Neoplasia Versus Diminutive Adenomas

Current postpolypectomy surveillance guidelines lump adenomas 1 to 9 mm in size together in a category of low-risk adenomas. Advanced adenomas are defined as those

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ASGE Journal Scan | Colon

What’s the Best Way to Examine Lynch Colons?

Because of the more rapid transformation of adenomas to cancer in Lynch syndrome, one often sees recommendations that colonoscopists performing Lynch examinations should be proven

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ASGE Journal Scan | Colon

Rising Rates of CRC in Young People: Not Unique to U.S.

It is now widely recognized that colorectal cancer (CRC) rates have been increasing in the U.S. in persons under age 50, while simultaneously decreasing in

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ASGE Journal Scan | Colon

Screening Rates Still Behind in Blacks

Blacks have higher colorectal cancer (CRC) incidence and mortality rates, develop CRC at a younger age, and are screened for CRC less often than whites

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ASGE Journal Scan | Colon

When Colonoscopy for a Positive Cologuard Is Negative, STOP the Workup

The Cologuard test from Exact Sciences looks for hemoglobin and abnormal DNA in the stool. Because abnormal DNA can be shed from the GI tract

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