Quality indicators for colonoscopy: Current insights and caveats |
| |
Authors: | Hendrikus JM Pullens Peter D Siersema |
| |
Affiliation: | Hendrikus JM Pullens, Department of Gastroenterology and Hepatology, Meander Medical Center, 3800 BM Amersfoort, The NetherlandsHendrikus JM Pullens, Peter D Siersema, Department of Gastroenterology and Hepatology, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands |
| |
Abstract: | Colonoscopy is the diagnostic modality of choice for investigation of symptoms suspected to be related to the colon and for the detection of polyps and colorectal cancer (CRC). Colonoscopy with removal of detected polyps has been shown to reduce the incidence and mortality of subsequent CRC. In many countries, population screening programs for CRC have been initiated, either by selection of patients for colonoscopy with fecal occult blood testing or by offering colonoscopy directly to average-risk individuals. Several endoscopy societies have formulated quality indicators for colonoscopy. These quality indicators are almost always incorporated as process indicators, rather than outcome measures. This review focuses on the quality indicators bowel preparation, cecal intubation rate, withdrawal time, adenoma detection rate, patient comfort, sedation and complication rate, and discusses the scientific evidence supporting them, as well as their potential shortcomings and issues that need to be addressed. For instance, there is still no clear and generally accepted definition of adequate bowel preparation, no robust scientific evidence is available supporting a cecal intubation rate ≥ 90% and the association between withdrawal time and occurrence of interval cancers has not been clarified. Adenoma detection rate is currently the only quality indicator that has been shown to be associated with interval colorectal cancer, but as an indicator it does not differentiate between subjects with one or more adenoma detected. |
| |
Keywords: | Colonoscopy Quality indicators Bowel preparation Cecal intubation Withdrawal time Adenoma detection rate Screening Complication Interval colorectal cancer Post-colonoscopy colorectal cancer |
本文献已被 CNKI 等数据库收录! |
| 点击此处可从《World journal of gastrointestinal endoscopy》浏览原始摘要信息 |
|