Quality indicators for colonoscopy.

https://www.giejournal.org/article/S0016-5107(14)02051-3/pdf

Quality indicators for colonoscopy

The British Society of Gastroenterology (BSG) and the Association of Coloproctology for Great Britain and Ireland (ACPGBI) commissioned this update of the 2002 guidance. The aim, as before, is to provide guidance on the appropriateness, method and frequency of screening for people at moderate and high risk from colorectal cancer. This guidance provides some new recommendations for those with inflammatory bowel disease and for those at moderate risk resulting from a family history of colorectal cancer. In other areas guidance is relatively unchanged, but the recent literature was reviewed and is included where appropriate.

https://gut.bmj.com/content/gutjnl/59/5/666.full.pdf

Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002)

https://www.gastrojournal.org/article/S0016-5085(07)00795-0/pdf

High Yields of Small and Flat Adenomas With High-Definition Colonoscopes Using Either White Light or Narrow Band Imaging

Colorectal cancer (CRC) is rapidly increasing in Asia, but screening guidelines are lacking. Through reviewing the literature and regional data, and using the modified Delphi process, the Asia Pacific Working Group on Colorectal Cancer and international experts launch consensus recommendations aiming to improve the awareness of healthcare providers of the changing epidemiology and screening tests available. The incidence, anatomical distribution and mortality of CRC among Asian populations are not different compared with Western countries. There is a trend of proximal migration of colonic polyps. Flat or depressed lesions are not uncommon. Screening for CRC should be started at the age of 50 years. Male gender, smoking, obesity and family history are risk factors for colorectal neoplasia. Faecal occult blood test (FOBT, guaiac-based and immunochemical tests), flexible sigmoidoscopy and colonoscopy are recommended for CRC screening. Double-contrast barium enema and CT colonography are not preferred. In resource-limited countries, FOBT is the first choice for CRC screening. Polyps 5-9 mm in diameter should be removed endoscopically and, following a negative colonoscopy, a repeat examination should be performed in 10 years. Screening for CRC should be a national health priority in most Asian countries. Studies on barriers to CRC screening, education for the public and engagement of primary care physicians should be undertaken. There is no consensus on whether nurses should be trained to perform endoscopic procedures for screening of colorectal neoplasia.

/pdf/asia-pacific-consensus-recommendations-for-colorectal-cancer-1k4lpsuqla.pdf

Asia Pacific consensus recommendations for colorectal cancer screening

ummary
Background
In 2002, a U.S. Multi-Society Task Force on Colorectal Cancer recommended that the withdrawal phase for colonoscopy should average at least 6–10 min. This was based on 10 consecutive colonoscopies by two endoscopists with different adenoma miss rates.

Aims
To characterize the relationship between endoscopist withdrawal time and polyp detection at colonoscopy, and to determine the withdrawal time that corresponds to the median polyp detection rate.

Design
Procedural data from out-patient colonoscopies performed at the Mayo Clinic, Rochester during 2003 were reviewed. Endoscopists were characterized by their mean withdrawal time for a negative procedure and individual polyp detection rate.

Results
A total of 10 955 colonoscopies performed by 43 endoscopists were analysed. Median withdrawal time was 6.3 min (range: 4.2–11.9); polyp detection rate was 44.0% (all polyps), 29.8% (≤5 mm), 5.9% (6–9 mm), 6.7% (10–19 mm), 2.1% (≥20 mm). Longer withdrawal time was associated with higher polyp detection rate (r = 0.76; P < 0.0001); this relationship weakened for larger polyps (r = 0.19 for polyps 6–9 mm, r = 0.28 for polyps 10–19 mm, r = 0.02 for polyps ≥20 mm). Overall median polyp detection rate corresponded to a withdrawal time of 6.7 min.

Conclusion
Our findings support a colonoscopy withdrawal time of at least 7 min, which correlates with higher colon polyp detection rates.

B. J. Ott

Papers

Impact of Endoscopist Withdrawal Speed On Polyp Yield: Implications for Optimal Colonoscopy Withdrawal Time