Colorectal cancer (CRC) is the most common tumor and the second leading cause of death in the Western world. The decrease in incidence and mortality by CRC in the population undergoing screening has been observed. Colonoscopy is the recommended method for detecting tumors in early stages, as well as identifying and resecting adenomatous polyps, which are the precursor lesions of most CRCs. Colonoscopy should be of high quality to decrease incidence and mortality by CRC and avoid interval cancer. The literature shows that colonoscopy does not prevent right colon lesions in the same way as the left colon lesions, with most of the interval cancers located in the right colon. Studies published so far show an increase in the adenomas detection rate (ADT) in the right colon in the second visualization of this segment and an increase between 2 and 10% if this second examination is performed with the proximal retroflexion maneuver.Retroflexion is a safe maneuver in expert endoscopists. The aim of our study is to evaluate the ADT in the right colon by means of a second visualization by performing proximal retroflexion or second frontal visualization at random in the CCR screening population.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
SINGLE
Enrollment
692
The investigator explore twice right colon, first front view and second forward viewing or proximal retroflexion depends on randomization
The investigator explore twice right colon with frontal viewing
Hospital Universitario Rio Hortega
Valladolid, Spain
Proximal retroflexion improve adenoma detection rate in colorectal cancer screening
Determine whether to perform retroflexion proximal improves adenoma detection rate in the right colon versus forward vision in population screening colorectal cancer with medium risk with immune blood test positive stool
Time frame: through study completion, an average of 1 year
Second look for right colon improve adenoma detection rate
Determine if a second look: retroflexion proximal or forward view improve adenoma detection rate
Time frame: through study completion, an average of 1 year
Rate of retroflexion related adverse events
Time frame: through study completion, an average of 1 year
Rate of retroflexion proximal adverse events with a pediatric colonoscopy
Time frame: through study completion, an average of 1 year
Pre-procedure factors
To analyze pre-procedure factors that may influence the prevalence of precursor lesions in the colon: age, sex, race, alcohol, smoking habit and the value of SOH, in which more detailed explorations should be performed using proximal retroflexion
Time frame: through study completion, an average of 1 year
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