Masterclass: Colorectal Screening Plus (On-Demand) | September 2025-Tool Talk: How Invasive Screening Modalities Shape CRC Success

Video Transcription

Video Summary

Dr. Joseph Anderson discusses invasive colorectal cancer screening methods, focusing on flexible sigmoidoscopy and colonoscopy advancements. Flexible sigmoidoscopy, used mainly without sedation in the 80s and 90s, showed effectiveness in reducing colorectal cancer incidence and mortality, especially in men. However, its limitations include incomplete colon visualization, lower effectiveness in women due to anatomical challenges, and cost inefficiencies leading to decreased use. Colonoscopy, established as the more comprehensive screening, overcame sigmoidoscopy's limitations by enabling full mucosal visualization. Key factors affecting colonoscopy completion rates include patient characteristics (e.g., sex, BMI), scope technology advances (e.g., pediatric, variable stiffness, and tapered scopes), and endoscopist expertise. Studies highlight the importance of achieving at least 95% completion to reduce missed lesions, particularly in challenging cases like thin women and obese men. Increasing obesity rates pose procedural difficulties, and concerns rise over deep sedation usage, such as propofol. Future considerations include developing new scope designs and refining insertion techniques to improve completion rates and quality of colorectal cancer screening. Overall, technological improvements and enhanced training have significantly improved colonoscopy effectiveness, solidifying it as the preferred invasive screening modality for colorectal cancer.

Asset Subtitle

Joseph C. Anderson

Keywords

colorectal cancer screening

flexible sigmoidoscopy

colonoscopy advancements

screening completion rates

scope technology

patient characteristics

sedation concerns