Dye-Based Chromoendoscopy Improves Adenoma Detection Rates During Colonoscopy

Colorectal cancer screening from colonoscopy
Colorectal cancer screening from colonoscopy
Using a meta-analysis of randomized controlled trials, researchers assessed the efficacy of dye-based chromoendoscopy for detecting adenomas during colonoscopy.

Dye-based chromoendoscopy (CE) results in a higher adenoma detection rate (ADR) compared with conventional colonoscopy (CC), according to a study published in Gastrointestinal Endoscopy.

Researchers conducted a meta-analysis using 10 randomized controlled trials to assess differences in ADR between CE and CC. All trials included at least 50 patients, aged 18 years and older, without inflammatory bowel disease, who were undergoing nonemergency colonoscopy.

The primary outcomes of the study were ADR and mean number of adenomas or carcinomas detected per patient (MAP). Secondary outcomes included the total number of polyps detected and the number of adenomas detected per person based on lesion location.

Pooled ADR was higher in patients who underwent CE compared with patients who underwent CC, at 48.1% and 39.8%, respectively (relative risk [RR], 1.20; 95% CI, 1.11-1.29; I2=29%). MAP was reported in 9 studies and was statistically higher for patients in the CE group (0.92; 95% CI, 0.72-1.11) vs the CC group (0.62; 95% CI, 0.43-0.82).

Detection of any histology of polyp was higher in the CE group. The use of CE compared with CC was most notable for the detection of right-sided adenomas. Using data from 6 studies, the mean difference in detection was 0.28 (95% CI, 0.14-0.43; P =.011). CE also had a higher detection of distal adenomas, though not statistically significant.

“According to our analysis, dye-based chromoendoscopy increased adenoma detection rate and adenomas per colonoscopy by 20% and 50%, respectively, in patients at average or increased risk of CRC, corresponding to a Number Needed to Treat (NNT) to detect one additional patient with adenoma of 12,” the study authors noted.

Study limitations included some heterogeneity in the results for MAP, total number of polyps per person, and adenomas detected per person based on lesion location. Additionally, the impact of clinician experience or skill in identifying lesions was not considered.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Antonelli G, Correale L, Spadaccini M, et al. Dye-based chromoendoscopy for the detection of colorectal neoplasia: meta-analysis of randomized controlled trialsGastrointest Endosc. Published online May 16, 2022. doi:10.1016/j.gie.2022.05.002