Advantage of second-generation Endocuff vision® in screening for colonic polyps in routine practice: A comparative prospective and retrospective cohort study

Objective: Polyp detection rates (PDR) and adenoma detection rates (ADR) are indicators of colonoscopy performance and are directly correlated with the risks of interval cancer and death from colon cancer. More than half of interval cancers are linked to undetected lesions. The aim of this study is to determine whether second-generation Endocuff® vision (EVC) improves the detection of colonic adenomas and polyps in routine practice. Methods: This is a non-randomized, open-label, single-center study comparing pre-existing data from conventional colonoscopy obtained in routine practice at the institution in the period from June 1 to July 22, 2017 (retrospective period) on 515 subjects without EVC, and 521 patients with the EVC device from October 18, 2018 to September 30, 2019, after information and collection of consent (prospective period). These two periods were consecutive in order to limit selection bias. The primary endpoint corresponded to the detection of the rate of adenomas, performed by conventional colonoscopy or with EVC. The trial was analyzed by a proportion comparison test between groups for independent data on the primary endpoint. Results: The rate of detection of at least one adenoma increased with the Endocuff® device from 16.83% to 21.11% (P=0.036). Better preparation with a Boston score = a score of 9 resulted in an increase in adenoma detection rate, which went from 19.76% to 26.68% (p=0.003). With EVC, a progression time of less than five minutes is preferable for improving the adenoma detection rate (RR = 1.141 [1.130 to 1.752], P=0.0013), and a withdrawal time of between six and ten minutes (RR = 1.449 [1.161 to 1.810], P=0.0027). Conclusion: The use of the Endocuff® system improves the detection of adenomas during colonoscopy, for the patients with a family or personal history of polyps or colon cancers and for the patients with a BMI >30. It is therefore an indispensable tool when it comes to detecting adenomas during colonoscopy. There were no associated complications [3, 5]. Trial registration number: NCT NCT03758872