Comparing autofluorescence endoscopy and white light video endoscopy for surveillance of patients with familial colorectal cancer.

Objective:
To compare the sensitivity of autofluorescence endoscopy (AFE) and white light video endoscopy (WLE) for the detection of colorectal adenomas in high-risk patients belonging to Lynch syndrome (LS) or familial colorectal cancer (CRC) families.
Design:
Prospective single centre study.
Setting:
Tertiary referral centre.
Population:
Asymptomatic patients originating from Lynch syndrome or familial colorectal cancer families.
Intervention:

Patients were examined with either WLE followed by AFE or AFE followed by WLE. Back-to-back colonoscopy was performed by two blinded endoscopists. All lesions were removed during the second endoscopic procedure. Lesions missed during the second procedure were identified and removed on 3rd pass. The sensitivity calculations for colorectal adenomas were based on histology results.
Outcome measure:
The difference in sensitivity between WLE and AFE for the detection of adenomas in patients with LS or familial CRC.
Analysis:
McNemar’s test, the Mann-Whitney U test, the Fisher exact test, the t-test and multivariable proportional odds logistic regression analysis.

Autofluorescence endoscopy (AFE) has a higher sensitivity for the detection of colorectal adenomas in comparison with white light video endoscopy (WLE).

Interim analysis after inclusion of fifty participants.

Colonoscopic surveillance with both WLE and AFE in high risk patients (Lynch syndrome or familial colorectal cancer). In case of the detection of colorectal lesions (adenoma, colorectal cancer or hyperplasia) these lesions were removed by polypectomy. AFE was compared to WLE (active control) with respect to the diagnostic yield (detection of colorectal lesions).