Endoscopy 2025; 57(S 02): S207
DOI: 10.1055/s-0045-1805510
Abstracts | ESGE Days 2025
Moderated poster
Diagnosis and performance in endoscopy: an update 03/04/2025, 16:00 – 17:00 Poster Dome 1 (P0)

Enhancing colorectal polyp detection with real-time quality control in colonoscopy

S Nissinen
1   Itä-Suomen yliopisto, Hämeenlinna Finland
,
M Puhto
2   Mikkeli Central Hospital, Mikkeli, Finland
,
J Aho
3   Scopia.app, Helsinki, Finland
,
J Varis
3   Scopia.app, Helsinki, Finland
,
A Aitkoski
4   Tampere university hospital, Tampere, Finland
,
T Rantanen
5   University of Eastern Finland, Kuopio, Finland
6   Kuopio University Hospital, Kuopio, Finland
› Author Affiliations
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Aims Colonoscopy effectively reduces colorectal cancer (CRC) incidence and mortality, but significant variability in precancerous lesion detection persists among endoscopists. The importance of real-time quality control is well established in industry. This study aimed to evaluate the impact of real-time quality control on polyp detection rates in colonoscopy.

Methods We compared two prospectively collected datasets from colonoscopies performed at Mikkeli Central Hospital in Finland. It is a unit with a longstanding emphasis on quality control and adherence to ESGE recommendations [1] [2] [3] [4] [5] [6]. In the first dataset (March 2023–March 2024), data were manually recorded by endoscopy nurses into Excel form. In the second dataset (April–October 2024), Scopia.app, a real-time colonoscopy quality control tool, was used for data collection during procedures. All colonoscopies were performed by experienced endoscopists with at least 500 prior procedures. Data included patient demographics (age, sex, indication, prior colonoscopy history) and procedural quality metrics such as bowel preparation quality (Boston Bowel Preparation Score), cecal intubation rate (CIR), mean number of polyps detected per 100 procedures (MNP), and polyp detection rate (PDR%). Inclusion criteria were patients aged≥50 years. Exclusion criteria included planned operative colonoscopy, prior colonoscopy within three years, or non-prepared colon. Statistical analyses were performed using unpaired t-tests, with significance set at p<0.05 (two-tail).

Results Six endoscopists performed 1,493 colonoscopies (1044 included) in the first dataset and 908 colonoscopies (543 included) in the second dataset. Patients' mean age was the same 68 years (SD=8.40 vs. 9.13 respectively) in the first and the second datasets. Modest improvements were observed in the second dataset: The unit’s CIR increased from 95.7% to 97.8%; MNP rose from 169 to 171 per 100 procedures; and PDR improved from 58.0% to 64.1%, though these differences were not statistically significant. Two endoscopists with initially lower detection rates demonstrated significant improvement. For one endoscopist, MNP increased from 88 to 191 per 100 procedures (n=96 vs. n=44, p=0.003), and PDR improved from 42.7% to 63.4% (p=0.02) correspondingly. For the other, MNP rose from 83 to 149 per 100 procedures (n=126 vs. n=51, p=0.013) and PDR improved from 41.3% to 56.9% (p=0.06, NS) correspondingly.

Conclusions Real-time quality control proved to be a reliable tool for improving colonoscopy performance, even in a unit already exceeding ESGE recommendations. It effectively improved performance among those with initially lower polyp detection rates. Polyp detection play an important role in the prevention of colorectal cancer. We encourage further research to generalise these results and assess real-time quality control impact on other quality indicators and long-term outcomes.



Publication History

Article published online:
27 March 2025

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