Novel colonoscopic imaging techniques.

RK Colonoscopy is considered to be the gold standard of colon cancer screening. In fact, colonoscopy has been shown to reduce colon cancer mortality by approximately 50%. However, colonoscopy is not as effective on the right side of the colon as it is on the left side of the colon. Flat and serrated adenomas (precancerous conditions) are more common on the right side of the colon and harbor an increased cancer risk. Multiple studies have shown that these lesions can easily be overlooked. Moreover, tandem, or back-to-back, colonoscopies have shown that at least 20% of adenomas are overlooked, which can lead to interval cancers (new or overlooked cancers that develop despite the performance of colonoscopy and recommendation of surveillance). In addition, it has been shown that the quality of bowel preparation, experience of the endoscopist, and use of new endoscopic techniques can increase the adenoma detection rate. A recent study from Poland showed that a greaterthan-20% adenoma detection rate almost eliminated the risk of interval cancers. Thus, quality markers (eg, complete colonoscopy rate, withdrawal time, adenoma detection rate, and cleanliness of the colon) have to be measured and monitored to produce high-quality colonoscopy. New colonoscopy techniques are being developed with the goal of further increasing detection rates and improving the prediction of the final histology of colorectal lesions.