A safe and effective test to evaluate your colon for polyps and abnormalities is a colonoscopy. There are literally hundreds of thousands of gastroenterologists in the United States who perform colonoscopies, so the quality of a colonoscopy can vary quite a bit. Withdrawal time is one quality measure that can distinguish a good gastroenterologist from a great one. Withdrawal time is the amount of time that it takes for your gastroenterologist to remove the colonoscope after reaching the beginning of the colon called the cecum.
Historically, higher adenoma detection rates are associated with increased withdrawal time (of at least six minutes). When a gastroenterologist spends a longer time examining the intestinal wall, there is an increased chance of finding and removing precancerous polyps that could develop into colon cancer.
Segmented withdrawal refers to a gastroenterologist spending more time inspecting the right colon, the first part of the colon that is joined to the small intestine. Right-sided colon cancer is:
- often missed because patients often do not experience bleeding or an obstruction
- more likely to metastasize to the liver
- less likely to cause symptoms
- more likely to present in advanced stages
Colon cancer is highly treatable in the early stages, but advanced colon cancer can metastasize to other parts of the body and be very difficult to contain and treat.
Yi Jia, M.D., Ph.D., of Texas Tech University Health Sciences Center at El Paso, worked with a team of colleagues to determine how increased withdrawal time and segmental withdrawal time affected polyp and adenoma detection.
Jia and colleagues randomly tested 326 patients by segmental withdrawal or standard nonsegmental withdrawal. The patients were also randomly assigned to a 6-minute or 8-minute protocol, which resulted in four study groups.
After reviewing the results, Jia stated, “Our study did not find a significant difference in ADR between timed segmental withdrawal and standard withdrawal at either 6 minutes or 8 minutes withdrawal time. However, we did find a trend for segmental withdrawal to be superior compared with nonsegmental withdrawal in some minor parameters.”
Jia said that further study needs to be done, but it does appear that segmented withdrawal (spending more time evaluating the right side of the colon) may increase adenoma detection rate and polyp detection rate (Source: Healio).