Published online Jul 27, 2022. doi: 10.4240/wjgs.v14.i7.632
Peer-review started: February 7, 2021
First decision: March 16, 2021
Revised: May 2, 2021
Accepted: June 20, 2022
Article in press: June 20, 2022
Published online: July 27, 2022
Colonoscopy represents the most widespread and effective tool for the prevention and treatment of early stage preneoplastic and neoplastic lesions in the panorama of cancer screening. In the world there are different approaches to the topic of colorectal cancer prevention and screening: different starting ages (45-50 years); different initial screening tools such as fecal occult blood with immunohistochemical or immune-enzymatic tests; recto-sigmoidoscopy; and colonoscopy. The key aspects of this scenario are composed of a proper bowel preparation that ensures a valid diagnostic examination, experienced endoscopist in detection of preneoplastic and early neoplastic lesions and open-minded to upcoming artificial intelligence-aided examination, knowledge in the field of resection of these lesions (from cold-snaring, through endoscopic mucosal resection and endoscopic submucosal dissection, up to advanced tools), and management of complications.
Core Tip: Appropriate bowel preparation is related with valuable outcomes in colorectal cancer screening. Artificial intelligence may represent an adjunctive methodology for standardizing endoscopy practice. Cold snare polypectomy emerged as a new approach for resection of superficial benign lesions. Endoscopic submucosal dissection has been widely recognized as an indispensable procedure for early superficial neoplastic lesions able to avoid unnecessary major surgery. Advanced techniques such as full-thickness resection and non-thermal avulsion represent valid tools for recurrent/non-lifting lesions.