NARROW BAND IMAGING vs HIGH DEFINITION COLONOSCOPY FOR DETECTION OF COLORECTAL ADENOMAS IN PATIENTS WITH POSITIVE FAECAL OCCULT BLOOD TEST: A RANDOMISED TRIAL

Background: the impact of narrow band imaging (NBI) in improving the adenoma detection rate (ADR) in a screening scenario is still unclear. Aim: the study aimed to evaluate whether NBI compared with high definition white light high definition colonoscopy (HD-WL) can enhance ADR during screening colonoscopy. Methods: eligible consecutive patients with positive immunologic fecal occult blood test presenting for colonoscopy were included into this randomized controlled study; they were randomly assigned to NBI or HD-WL group. The primary end point was the ADR, secondary aim was the detection rate of advanced adenomas. Results: 237 patients were included in the analysis, of whom 117 were allocated to the NBI arm and 120 to the HD-WL arm. The ADR was not significantly different between the two groups (NBI= 52.1% vs HD-WL= 55%, RR= 0.95, 95% CI 0.75-1.20) as well as the detection rate of advanced adenomas (NBI= 32.5% vs HD-WL= 44.2%, RR= 0.74, 95% CI 0.53-1.02). No significant difference between the proportions of polypoid and flat adenomas was found according to the type of examination. Conclusions: in a screening scenario, NBI did not improve ADR or detection rate of advanced adenomas.