1.1 Evidence supports the case for adopting Endocuff Vision in the NHS because it improves the adenoma detection rate during colonoscopy, particularly for people having a colonoscopy as part of bowel cancer screening.
1.2 Endocuff Vision should be considered as an option for people having a colonoscopy as part of bowel cancer screening following a positive stool test. There is limited evidence for the benefits of Endocuff Vision in a non-screening population.
1.3 Cost modelling shows that for people having a colonoscopy as part of bowel cancer screening, using Endocuff Vision is cost saving. Savings are related to the adenoma detection rate; for a colonoscopist with a baseline adenoma detection rate of 51%, using Endocuff Vision saves £53 per patient over 10 years compared with standard colonoscopy.
Why the committee made these recommendations
The bowel cancer screening programme is an NHS service that offers tests (including colonoscopy) to people who are at risk of bowel cancer. Colonoscopy is used to detect bowel cancer but also to identify and remove adenomas that could develop into cancerous lesions if left untreated.
Endocuff Vision is a disposable sleeve that fits over the end of most colonoscopes. It is designed to improve visualisation of the bowel during colonoscopy.
Clinical evidence shows that for people having a colonoscopy as part of bowel cancer screening, using Endocuff Vision improves the adenoma detection rate without increasing how long the procedure takes. Better detection of adenomas is likely to reduce the incidence of subsequent cancers. Cost analyses in this population also suggest that Endocuff Vision is cost saving if the adenoma detection rate is improved by more than 3%.
The clinical and cost effectiveness of Endocuff Vision in other populations (such as people having a colonoscopy unrelated to bowel screening) is less certain because of the limited evidence available.