[Quality of colonoscopy defines the success of colorectal cancer screening]

Abstract

It is estimated that nationwide screening for colorectal cancer in the Netherlands will necessitate 66,000 colonoscopies per year. The quality of a colonoscopy depends on the operator. Recently, quality indicators for colonoscopies performed by 5 endoscopists at a large Dutch hospital were compared. The percentage of successful colonoscopies per endoscopist ranged from 88-97% and the adenoma detection rate (ADR) between 27-52%. The authors concluded that the variation between these operators was great, but within proposed quality limits. The number of procedures each operator had performed, however, is too small to draw this conclusion. In addition, ADRs were not adjusted for important differences between the patients. The study shows that, in addition to operator expertise, several other factors determine the quality of a colonoscopy. Given its central role in national colon cancer screening, methods for assuring the quality of colonoscopy are urgently needed.