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New Device May Show Doctors More of the Colon

Advanced colonoscope has wider range of view than traditional models, picks up more polyps, study finds
SATURDAY, May 18, 2013 (HealthDay News) -- A new device that gives doctors a better view during colonoscopies may help them miss fewer suspicious growths during those exams, a new study shows.
Colonoscopies are the recommended screening tests for colorectal cancer, which is the second leading cancer killer of men and women in the United States.
To perform a colonoscopy, doctors use a long, flexible tube with a camera mounted on the end called a colonoscope to view the lining of the large intestine.
The basic design of those devices hasn't changed in about 30 years, said study author Dr. Ian Gralnek, a senior physician at the department of gastroenterology at Rambam Health Care Campus and Elisha Hospital in Haifa, Israel.
And the design isn't perfect. A February 2006 study published in the American Journal of Gastroenterology found that traditional colonoscopies missed 22 percent of polyps. Polyps are fleshy growths on the walls of the colon that can turn into cancers if they aren't removed.
Part of the problem, Gralnek explained, is that scopes only have one forward-facing camera, which gives doctors a 170-degree view. That makes it easy to miss polyps, which often grow behind fleshy folds on the colon walls.
To improve detection, an Israeli company has designed a new colonoscope, called the Full Spectrum Endoscopy, or FUSE. The FUSE colonoscope uses three cameras mounted on the front and sides of a flexible arm to give doctors a 330-degree view as they work. EndoChoice of Alpharetta, Ga., the company that's acquired the rights to the device, funded the study.
Gralnek tested the new technology by asking 183 stalwart patients to undergo back-to-back colonoscopies.
About half of the patients were randomly assigned to have a colonoscopy with a traditional colonoscope, followed by the same test using the new FUSE scope. In the other half, the order of the tests was reversed.
During the first test, doctors found and removed as many polyps as they could see. They used the second test to count the number of polyps that were missed on the first go-round.
The FUSE scope missed about 8 percent of adenomas -- small, flat polyps that are especially concerning to doctors because they can turn into full-blow cancers. The standard colonoscopes missed about 43 percent of those growths.
"You really see a lot better [with the FUSE scope]," Gralnek said. "The natural anatomy of the colon has these folds. You can miss polyps on the back sides of these folds and at some of the twists and turns within the colon itself. Because of the extra cameras we're seeing a lot more of the colon itself."
An expert who was not involved in the research says the technology is worth further study.
"These are important data," said Dr. Frank Sinicrope, a professor of medicine and oncology at the Mayo Clinic in Rochester, Minn.
But Sinicrope said it's still not clear whether the new technology will actually prevent more colon cancers than traditional colonoscopies do.
"Detecting more polyps and adenomas does not necessarily indicate that a reduction in cancer risk or mortality will result, since many small adenomas may never develop into cancers," he pointed out.
It's logical that finding more adenomas would make the test more effective, but he points out that hasn't been proven yet.
The study was to be presented Saturday at the Digestive Diseases Week annual meeting in Orlando.
Research findings presented at medical conferences are considered preliminary because they haven't yet had the scrutiny that's required for publication in a peer-reviewed journal.
Until the new technology is ready for widespread use, the most important thing to do is to go for a colonoscopy.
The American Cancer Society recommends that men and women of average risk get colonoscopies every 10 years, starting at age 50.
More information
For more on colonoscopies, head to the U.S. National Institutes of Health (http://digestive.niddk.nih.gov/ddiseases/pubs/colonoscopy ).
SOURCES: Ian Gralnek, M.D., deputy chief, department of gastroenterology, Rambam Health Care Campus, Elisha Hospital, Haifa, Israel; Frank Sinicrope, M.D., professor, medicine and oncology, Mayo Clinic, Rochester, Minn; May 18, 2013, presentation, Digestive Diseases Week annual meeting, Orlando
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