Endoscopy 2020; 52(S 01): S63-S64
DOI: 10.1055/s-0040-1704199
ESGE Days 2020 oral presentations
Thursday, April 23, 2020 16:30 – 18:00 Improving outcomes in Wicklow Meeting Room 3GI- endoscopy
© Georg Thieme Verlag KG Stuttgart · New York

COLONOSCOPY QUALITY ASSURANCE IN AN ORGANIZED FIT-BASED COLORECTAL CANCER SCREENING PROGRAM

MCW. Spaander
1   Erasmus MC University Medical Center, Gastroenterology and Hepatology, Rotterdam, Netherlands
,
PHA Wisse
1   Erasmus MC University Medical Center, Gastroenterology and Hepatology, Rotterdam, Netherlands
,
SY de Boer
2   Slingeland Ziekenhuis, Gastroenterology and Hepatology, Doetinchem, Netherlands
,
B den Hartog
3   Meander Medical Center, Gastroenterology and Hepatology, Amersfoort, Netherlands
,
M. Oudkerk Pool
4   Treant Zorggroep, Gastroenterology and Hepatology, Hoogeveen, Netherlands
,
JST Sive Droste
5   Jeroen Bosch Hospital, Gastroenterology and Hepatology, Den Bosch, Netherlands
,
C. Verveer
6   Ikazia Hospital, Gastroenterology and Hepatology, Rotterdam, Netherlands
,
FG van Maaren-Meijer
7   Dutch Colorectal Cancer Screening Organisation, Rotterdam, Netherlands
,
E Dekker
8   Amsterdam University Medical Centre, location Academic Medical Centre, University of Amsterdam, Gastroenterology and Hepatology, Amsterdam, Netherlands
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims High quality colonoscopy is essential for optimal performance of a colorectal cancer (CRC) screening program. Therefore, endoscopists performing within the Dutch CRC screening program have to receive accreditation and fulfill minimum standards. In this study we assessed the quality of colonoscopies performed by the certified endoscopists.

Methods We obtained data for all first colonoscopies after a positive FIT (2014-2018). We determined quality indicators regarding completeness of visualization (cecal intubation rate [CIR], bowel preparation and withdrawal time [CWT]), removal rates (procedures with all polyps removed [PRR]), detection rates (cancer detection rate, adenoma detection rate [ADR], mean number of adenomas per procedure [MAP] and per positive procedure [MAP+]) and patient satisfaction (Gloucester comfort score). We evaluated minimum standards for CIR (≥95%), bowel preparation (≥90% sufficient), CWT (≥90% ≥6 minutes), PRR (≥90%) and ADR (≥30%) for each endoscopist who performed ≥50 colonoscopies. We assessed CWT in colonoscopies without detected lesions.

Results In total 431 endoscopists performed 237,092 first colonoscopies. In these colonoscopies, CIR was 97.0%, bowel preparation was sufficient in 97.5%, CWT was ≥6 minutes in 96.7% and PRR was 96.4%. CRC detection rate was 7.3%, ADR was 64.2%, MAP was 1.7 and MAP+ was 2.5. Patients experienced moderate or severe discomfort in 4.2% of colonoscopies. Of all endoscopists, 401/431 (93.0%) performed ≥50 colonoscopies. Minimum standards for CIR, bowel preparation, CWT and PRR were met by ≥90% of these endoscopists. All endoscopists achieved ADR ≥30%, moreover ADR was ≥40% for 399 endoscopists (99.5%) and ≥50% for 396 endoscopists (98.8%).

Conclusions Colonoscopies, performed after a positive FIT in the Dutch CRC screening program, are of high quality. All minimum standards are met by over 90% of endoscopists. ADR is much higher than the current minimum standard, so the minimum standard for ADR should be increased to ≥40% for optimal quality assurance in FIT-based CRC screening programs.