Endoscopy 2020; 52(S 01): S73
DOI: 10.1055/s-0040-1704222
ESGE Days 2020 oral presentations
Friday, April 24, 2020 08:30 – 10:30 How to maximize quality in Liffey Meeting Room 1GI-endoscopy?
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COLONOSCOPY QUALITY AFTER INTENSIVE TRAINING OF INEXPERIENCED ENDOSCOPISTS IN A NORWEGIAN SCREENING TRIAL FOR COLORECTAL CANCER

AL Schult
1   Cancer Registry of Norway, Section for Colorectal Cancer Screening, Oslo, Norway
2   Vestre Viken Hospital Trust Bærum, Department of Medicine, Gjettum, Norway
3   University of Oslo, Institute of Clinical Medicine, Oslo, Norway
,
KR Randel
1   Cancer Registry of Norway, Section for Colorectal Cancer Screening, Oslo, Norway
4   Telemark Hospital Trust, Department of Research and Development, Skien, Norway
5   University of Oslo, Institute of Health and Society, Oslo, Norway
,
E Botteri
1   Cancer Registry of Norway, Section for Colorectal Cancer Screening, Oslo, Norway
,
G Hoff
1   Cancer Registry of Norway, Section for Colorectal Cancer Screening, Oslo, Norway
3   University of Oslo, Institute of Clinical Medicine, Oslo, Norway
4   Telemark Hospital Trust, Department of Research and Development, Skien, Norway
,
M Bretthauer
6   University of Oslo, Clinical Effectiveness Research Group, Institute of Health and Society, Oslo, Norway
7   Oslo University Hospital, Department of Transplantation Medicine, Oslo, Norway
,
G Ursin
8   Cancer Registry of Norway, Oslo, Norway
9   University of Oslo, Institute of Basic Medical Sciences, Oslo, Norway
10   University of Southern California, Department of Preventive Medicine, Los Angeles, USA
,
E Natvig
1   Cancer Registry of Norway, Section for Colorectal Cancer Screening, Oslo, Norway
,
A Jørgensen
1   Cancer Registry of Norway, Section for Colorectal Cancer Screening, Oslo, Norway
,
P Sandvei
11   Østfold Hospital Trust, Department of Gastroenterology, Grålum, Norway
,
MK Ek Olsen
12   Østfold Hospital Trust, Department of Pathology, Grålum, Norway
,
SO Frigstad
2   Vestre Viken Hospital Trust Bærum, Department of Medicine, Gjettum, Norway
3   University of Oslo, Institute of Clinical Medicine, Oslo, Norway
,
O Darre-Næss
2   Vestre Viken Hospital Trust Bærum, Department of Medicine, Gjettum, Norway
,
ER Norvard
13   Vestre Viken Hospital Trust Drammen, Department of Pathology, Drammen, Norway
,
H Kørner
14   Stavanger University Hospital, Department of Gastrointestinal Surgery, Stavanger, Norway
15   University of Bergen, Department of Clinical Medicine, Bergen, Norway
,
A Wibe
16   Norwegian University of Science and Technology, Trondheim, Norway
17   Trondheim University Hospital, Department of Surgery St Olavs Hospital, Trondheim, Norway
,
T de Lange
3   University of Oslo, Institute of Clinical Medicine, Oslo, Norway
18   Vestre Viken Hospital Trust Bærum, Department of Medical Research, Gjettum, Norway
,
Ø Holme
1   Cancer Registry of Norway, Section for Colorectal Cancer Screening, Oslo, Norway
6   University of Oslo, Clinical Effectiveness Research Group, Institute of Health and Society, Oslo, Norway
19   Sorlandet Hospital Trust, Department of Medicine, Kristiansand, Norway
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims High-quality colonoscopies are essential to achieve an effective colorectal cancer (CRC) screening program. Limited colonoscopy capacity is a bottleneck for CRC screening. To inform the Norwegian health authorities of the feasibility of CRC screening, a screening pilot project was launched. Most of the endoscopists who performed the screening colonoscopies had little endoscopy experience and were given intensive training (one-to-one supervision by an experienced endoscopist) for three to six months before performing endoscopies. The aim of this work is to show colonoscopy performance of inexperienced endoscopists.

Methods The project was introduced as a randomised effectiveness trial comparing once-only sigmoidoscopy and biennial fecal immunochemical testing (FIT). A positive screening test was followed by a colonoscopy. Colonoscopies were performed between 2012 and 2019. We measured well-established quality performance indicators: cecum intubation rate (CIR), mean withdrawal time for diagnostic colonoscopies, adenoma detection rate (ADR). We calculated these measures for the first colonoscopy per participant, performed by an inexperienced endoscopist who had performed ≥100 colonoscopies in the course of the trial. We state the patient reported outcomes abdominal pain and satisfaction in colonoscopies performed between 2012-2018.

Results Between 2012 and 2019, 8,857 colonoscopies were performed. The CIR was 97.2% (95% confidence interval [CI] 96.8%-97.5%). The mean withdrawal time was 13.6 minutes (95% CI 13.3-14.0 minutes). ADR after positive FIT was 57.7% (95% CI 56.4-59.0); 51.3% (95% CI 49.3%-53.2%) for women and 62.8% (95% CI 61.1%-64.4%) for men. The feed-back questionnaire was completed by 85.6% regarding pain and 72.4 % of participants regarding satisfaction. 9.5% of colonoscopy participants who submitted the form, experienced severe pain and 91.1% were very content with the examination.

Conclusions Colonoscopies performed by newly trained endoscopists were performed with high quality, achieving recommended benchmark standards. Our results confirm that intensive training of inexperienced endoscopists is feasible in a screening setting with good results.