Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2021; 27(3): 233-239
Published online Jan 21, 2021. doi: 10.3748/wjg.v27.i3.233
Screening colonoscopy: The present and the future
Chelsea V Hayman, Dinesh Vyas
Chelsea V Hayman, Dinesh Vyas, College of Medicine, California Northstate University, Elk Grove, CA 95757, United States
Dinesh Vyas, Department of Surgery, San Joaquin General Hospital, French Camp, CA 95231, United States
Author contributions: Hayman CV and Vyas D contributed to this paper; Vyas D designed the overall concept and outline of this manuscript; Hayman CV and Vyas D contributed to the discussion and design of the manuscript; Hayman CV contributed to the writing, and editing of the manuscript, illustrations, and review of the literature
Conflict-of-interest statement: Chelsea V Hayman and Dinesh Vyas have nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dinesh Vyas, MD, MSc, Associate Professor, Director, Surgeon, Department of Surgery, San Joaquin General Hospital, 500 West Hospital Road, French Camp, CA 95231, United States. dineshvyas@yahoo.com
Received: October 16, 2020
Peer-review started: October 16, 2020
First decision: October 27, 2020
Revised: November 10, 2020
Accepted: December 11, 2020
Article in press: December 11, 2020
Published online: January 21, 2021

In the United States, colorectal cancer (CRC) is the second leading cause of mortality in men and women. We are now seeing an increasing number of patients with advanced-stage diagnosis and mortality from colorectal cancer before 50 years of age, which requires earlier screening. With the increasing need for CRC screening through colonoscopy, and thus endoscopists, easier and simpler techniques are needed to train proficient endoscopists. The most widely used approach by endoscopists is air insufflation colonoscopy, where air distends the colon to allow visualization of the colonic mucosa. This technique is un-comfortable for patients and requires an anesthetist to administer sedation. In addition, patients commonly complain about discomfort post-op as air escapes into the small bowel and cannot be adequately removed. Current research into the use of water insufflation colonoscopies has proved promising in reducing the need for sedation, decreasing discomfort, and increasing the visibility of the colonic mucosa. Future direction into water insufflation colonoscopies which have shown to be simpler and easier to teach may increase the number of proficient endoscopists in training to serve our aging population.

Keywords: Colorectal cancer, Water-insufflation colonoscopy, Air-insufflation colonoscopy, Adenomatous polyps, Adenoma detection rate

Core Tip: Training residents in water-insufflation colonoscopy techniques are simpler and easier to teach and lead to a reduction in patient pain, need for sedation, and increased visibility of the colonic mucosa. As more endoscopists are comfortable with this technique, more people in our growing population will be able to obtain the necessary screening colonoscopies.