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

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

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

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

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

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

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

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

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,

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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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)

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

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

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

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

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

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

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

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

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

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,

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

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

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

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

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

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).

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

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

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

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

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

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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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).

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

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

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

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

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

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)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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)

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

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

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

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

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

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

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

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

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)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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