Standards of diagnostic colonoscopy for early‐stage neoplasia: recommendations by an Asian private group

Abstract

Background and Aim

In recent years, the incidence of colorectal cancer has been increasing, and it is now becoming the major cause of cancer death in Asian countries. The aim of this study was to develop Asian expert‐based consensus to standardize the preparation, detection and characterization for diagnosis of early‐stage colorectal neoplasia.

Methods

A professional group was formed by 36 expert the Asian Novel Bio‐Imaging and Intervention Group (ANBI²G) members. Representatives from 12 Asia‐Pacific countries participated at the meeting. The group organized three consensus meetings focusing on diagnostic endoscopy for gastrointestinal (GI) neoplasia. The Delphi method was used to develop the consensus statements.

Results

Through the three consensus meetings with debating, reviewing the literature and regional data, a consensus was reached at third meeting in 2016. The consensus was reached on a total of ten statements. The summary of statements is as follows: 1. Adequate bowel preparation for high quality colonoscopy; 2. Antispasmodic agents for lesion detection; 3. Image enhanced endoscopy (IEE) for polyp detection; 4. Adenoma detection rate for quality indicator; 5. Well documentation for colonoscopy finding; 6. Complication rates; 7. Cecal intubation rate; 8. Cap‐assisted colonoscopy for polyp detection; 9. Macroscopic classification using indigo carmine spray for characterization of colorectal lesion; and 10. IEE and/or magnifying endoscopy for prediction of histology.

Conclusion

This consensus provides guidance for the performance of endoscopic diagnosis and characterization for early stage colorectal neoplasia based on the evidence. This will enhance the quality of endoscopic diagnosis and improve detection of early‐stage colorectal neoplasia.

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