NIHR | September 2019 | Case study: ADENOMA – impact case study
NIHR has produced an impact case study on adenoma, a polyp that grows in the bowel that has become cancerous. Currently, a colonoscopy is regarded as the ‘gold standard’ treatment for adenoma.
Although experienced endoscopists perform the colonoscopies, polyps can get missed for various reasons including the size, shape and location of the lesions, and many colorectal cancer screening programmes have been proposed to improve adenoma detection rate (ADR). Improving the ADR and cancer detection through increased colonoscopy performance brings patient benefits, and earlier diagnosis of cancer is also associated with lower healthcare costs (Cancer Research UK 2014).
The study recruited 1800 participants from across seven sites, with patients being referred to the trial because of symptoms, surveillance or following a positive faecal occult blood test as part of the Bowel Cancer Screening Programme.
These patients were randomized across two arms of the trial: with one group having treatment as usual (the colonoscopy) and the other having the Endocuff Vision arm
The researchers report that the participants in the Endocuff Vision arm of the trial, had a higher Adenoma Detection Rate, increased globally from 36.2 per cent to 40.9 per cent (P=0.02). the increase was driven by a 10.8 per cent increase in FOBt-positive screening patients (50.9 per cent vs 61.7 per cent, P less than 0.001).
The research team conclude that the ADENOMA trial showed that Endocuff Vision significantly improved ADR in bowel cancer screening patients and should be used to improve colonoscopic detection.
The success of the trial led to NHS England announcing Endocuff Vision as one of only four technologies to be fast-tracked into use through NHS England’s Innovation and Technology Payment programme in April 2018.
NICE updated its guidelines for use in June 2019 and NHS trusts across England have significantly increased use of the product.
The Endocuff Vision device has also been adopted internationally and there has been a large rise in the use of the device over the last four years (Source: NIHR).
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