A comparison of high-definition versus conventional colonoscopes for polyp detection.

BACKGROUND: High-resolution, high-definition colonoscopes (HD) with 170 degrees angle of view providing brighter images, sharper resolution, and a 30 degrees wider field of view than conventional colonoscopes (CC) are available. The impact of these innovations on enhancing the detection of clinically important colonic lesions or over detection of clinically insignificant colonic lesions is not well established.

OBJECTIVES: To compare the difference in the detection of individuals with polyps, adenomas, or high-risk adenoma features between HD and CC. We also compared the difference in detection of individuals with clinically insignificant colonic lesions, >or=2, <6-mm hyperplastic polyps between HD and CC.

METHODS: Endoscopic findings from 426 individuals who underwent HD were compared to a cohort of 426 individuals who underwent CC after matching by gender, age (+/-5 years), and indication for colonoscopy based on propensity score. Conditional logistic regression was used to assess for differences in polyp detection rates and risk classification between the two groups.

RESULTS: HD affords no increase over CC in the detection of individuals with polyps, 39.9 vs. 36.9% (P = 0.34) or adenomas, 24.7 vs. 21.9% (P = 0.36). The proportion of subjects classified as high risk did not differ between the groups, 5.7% in the HD group and 4.5% in the CC group (P = 0.43) and 5.6% of each cohort was found to have >or=2, <6-mm hyperplastic polyps (P = 0.99).

CONCLUSIONS: HD colonoscopy does not increase the detection of individuals with polyps, adenomas, or high-risk adenoma features. HD does not increase the detection of individuals with clinically insignificant colonic lesions.