Enhanced versus standard white light colonoscopy for finding colorectal adenomas

Enhanced White Light Endoscopy Versus Conventional White Light Endoscopy for Colorectal Adenoma Detection: A Randomized Controlled Trial

This test will see if enhanced white light colonoscopy finds more colorectal adenomas and other polyps than standard white light colonoscopy in adults aged 45–85 having screening, a positive FIT, symptoms, or surveillance colonoscopy.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 800 (estimated)
• Ages: 45 Years to 85 Years
• Sex: All
• Sponsor: Shanghai Jiao Tong University School of Medicine (Academic / other)
• Locations: 7 sites (Chongqing, Chongqing Municipality and 6 other locations)
• Trial ID: NCT06979232 on ClinicalTrials.gov

What this trial studies

Adults aged 45–85 who are undergoing colonoscopy for screening, a positive fecal immunochemical test (FIT), gastrointestinal symptoms, or follow-up after polyp treatment are randomized 1:1 to receive colonoscopy with enhanced white light imaging (E-WLI) or high-definition conventional white light imaging (WLI). Procedures are performed by experienced endoscopists using endoscopes with Xiaohua Tanying E-WLI technology, with bowel preparation graded by the Boston Bowel Preparation Scale and cecal intubation confirmed by photographic documentation. Outcomes include adenoma detection rate, sessile serrated lesion detection, total polyp and advanced adenoma detection rates, polyp characteristics (size, location), and insertion/withdrawal times measured from video recordings. Randomization is centrally generated for each site and video review excludes time spent on therapeutic interventions while standard patient monitoring and anesthesia protocols are followed.

Who should consider this trial

Good fit: Adults 45–85 scheduled for colonoscopy for screening, a positive FIT, gastrointestinal symptoms, or surveillance after polyp treatment who can provide informed consent and follow study procedures are the intended participants.

Not a fit: Patients with prior inflammatory bowel disease, colorectal cancer or surgery, known polyposis syndromes, active gastrointestinal bleeding, pregnant or lactating patients, those currently in other interventional drug trials, or those outside the 45–85 age range are unlikely to be eligible or to benefit from this comparison.

Why it matters

Potential benefit: If successful, E-WLI could increase detection of adenomas and premalignant polyps, potentially reducing missed lesions and improving colorectal cancer prevention.

How similar studies have performed: Other image-enhancement methods such as narrow-band imaging and digital contrast enhancements have produced modest improvements in adenoma detection in prior studies, but the specific Xiaohua Tanying E-WLI system is relatively new and less extensively validated.

Eligibility criteria

Inclusion Criteria:

* 1\. Male or female aged 45 to 85
* 2\. Patients undergoing colonoscopy for colorectal cancer screening, positive fecal immunochemical test (FIT) results, gastrointestinal symptoms, or follow-up examination after colorectal polyp treatment
* 3\. Capable of providing informed consent and agreeing to participate
* 4\. Able and willing to follow all research processes

Exclusion Criteria:

* 1\. Participated in other clinical trials, signed informed consent form, and in the follow-up period of other clinical trials;
* 2\. Participated in clinical trials of drugs and is in the discontinuation period of experimental or control drugs;
* 3\. Have had drug or alcohol abuse or psychological disorders in the past five years.
* 4\. Pregnant or lactating patients;
* 5\. Known to have polyposis syndrome;
* 6\. Patients with gastrointestinal bleeding;
* 7\. Previous history of inflammatory bowel disease, colorectal cancer, or colorectal surgery;
* 8.Patients with contraindications to tissue biopsy;
* 9\. History of allergies to the ingredients in intestinal cleansers;
* 10\. Individuals with conditions such as intestinal obstruction or perforation, toxic megacolon, heart failure (grade III or IV), severe cardiovascular disease, severe liver failure, or renal insufficiency, among others.
* 11\. Researchers believe that patients are not suitable to participate in the trial.

Where this trial is running

Chongqing, Chongqing Municipality and 6 other locations

• Chongqing General Hospital — Chongqing, Chongqing Municipality, China (Active_not_recruiting)
• The First People's Hospital of Lanzhou City — Lanzhou, Gansu, China (Recruiting)
• The Third Affiliated Hospital of Heilongjiang University of Chinese Medicine — Harbin, Heilongjiang, China (Not_yet_recruiting)
• Armed Police Forces Hospital of Sichuan — Leshan, Sichuan, China (Recruiting)
• People's Hospital of Bayingolin Mongol Autonomous Prefecture — Korla, Xinjiang, China (Not_yet_recruiting)
• Ningbo Ninth Hospital — Ningbo, Zhejiang, China (Recruiting)
• Taizhou First People's Hospital — Taizhou, Zhejiang, China (Not_yet_recruiting)

Study contacts

• Study coordinator: Qing-Wei Zhang, MD

Conditions Colorectal Adenoma; Enhanced white light endoscopy; Adenoma detection rate; Randomized controlled trial