WASh multicentre randomised controlled trial: water-assisted sigmoidoscopy in English NHS bowel scope screening
| العنوان: | WASh multicentre randomised controlled trial: water-assisted sigmoidoscopy in English NHS bowel scope screening |
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| المؤلفون: | Matthew D, Rutter, Rachel, Evans, Zoe, Hoare, Christian, Von Wagner, Jill, Deane, Shiran, Esmaily, Tony, Larkin, Rhiannon, Edwards, Seow Tien, Yeo, Llinos Haf, Spencer, Emily, Holmes, Brian P, Saunders, Colin J, Rees, Zacharias P, Tsiamoulos, Iosif, Beintaris, Catherine, Lawrence |
| المصدر: | Gut. 70(5) |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Adenoma, Colorectal cancer, Context (language use), State Medicine, law.invention, Screening programme, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, medicine, Humans, Pain Management, Single-Blind Method, Patient Reported Outcome Measures, Sigmoidoscopy, Early Detection of Cancer, Pain Measurement, medicine.diagnostic_test, business.industry, Gastroenterology, Water, Middle Aged, medicine.disease, Clinical trial, Water assisted, England, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, business, Colorectal Neoplasms |
| الوصف: | ObjectivesThe English Bowel Cancer Screening Programme invites 55 year olds for a sigmoidoscopy (Bowel Scope Screening (BSS)), aiming to resect premalignant polyps, thus reducing cancer incidence. A national patient survey indicated higher procedural pain than anticipated, potentially impacting on screening compliance and effectiveness. We aimed to assess whether water-assisted sigmoidoscopy (WAS), as opposed to standard CO2 technique, improved procedural pain and detection of adenomatous polyps.DesignThe WASh (Water-Assisted Sigmoidoscopy) trial was a multicentre, single-blind, randomised control trial for people undergoing BSS. Participants were randomised to either receive WAS or CO2 from five sites across England. The primary outcome measure was patient-reported moderate/severe pain, as assessed by patients on a standard Likert scale post procedure prior to discharge. The key secondary outcome was adenoma detection rate (ADR). The costs of each technique were also measured.Results1123 participants (50% women, mean age 55) were randomised (561 WAS, 562 CO2). We found no difference in patient-reported moderate/severe pain between WAS and CO2 (14% in WAS, 15% in CO2; p=0.47). ADR was 15% in the CO2 arm and 11% in the WAS arm (p=0.03); however, it remained above the minimum national performance standard in both arms. There was no statistical difference in mean number of adenomas nor overall polyp detection rate. There was negligible cost difference between the two techniques.ConclusionIn the context of enema-prepared unsedated screening sigmoidoscopies performed by screening-accredited endoscopists, no difference in patient-reported pain was seen when using either a CO2 or WAS intubation technique.Trial registration numberISRCTN81466870. |
| تدمد: | 1468-3288 8146-6870 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ef9013dc5628783f031202f35a604b48 https://pubmed.ncbi.nlm.nih.gov/33214161 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....ef9013dc5628783f031202f35a604b48 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14683288 81466870 |
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