Quality Indicators in Colonoscopy

Screening colonoscopy has reduced incidence and mortality from colorectal cancer. However, the risk reduction depends on performing good quality Redding colonoscopy procedures. The American Society of Gastrointestinal Endoscopy has established quality indicators in this regard. 

The foremost among these is the frequency of detection of pre cancerous polyps, called adenomas. The colonoscopist must detect adenomas in at least 25% of their screening colonoscopies (30% for men and 20% for women). However this is a minimum. The higher the adenoma detection rate, the better the protection against post colonoscopy incidence of interval colon cancer.

Another is the withdrawal time. This is the time it takes to withdraw the scope from the cecum (last part of the colon) to the rectum. A minimum withdrawal time of 6 minutes is suggested.  However, withdrawal times of 8-10 minutes lead to better outcomes for patients.

Other quality indicator is the percentage of patients with good preparation leading to better visualization of the colon. This should be >85%. Also a colonoscopist must reach the cecum in at least 90% of his procedures.

At Redding Gastroenterology, Dr Paramvir Singh has an adenoma detection rate>50%, cecal intubation rate of 99% and withdrawal rate of >10 minutes.

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