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Am J Surg. 2019 Mar;217(3):442-444. doi: 10.1016/j.amjsurg.2018.09.009. Epub 2018 Sep 21.

Screening colonoscopy: High quality regardless of endoscopist specialty.

Author information

1
Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.
2
Department of Gastroenterology and Hepatology, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.
3
Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: valentm2@ccf.org.

Abstract

BACKGROUND:

Data suggests that screening colonoscopy performed by non-gastroenterologists are lower quality with lower adenoma detection rates (ADR). The aim of this study was to investigate the effect of the endoscopist's specialty on quality parameters in screening colonoscopy.

METHODS:

Screening colonoscopies performed between January 2016 and June 2017 were queried from a prospectively maintained institutional database. Quality parameters including overall ADR, gender-specific ADR, total examination time, cecal intubation rate and withdrawal time were compared between gastroenterology (GI) and colorectal surgery (CRS).

RESULTS:

A total of 15,276 patients were included in the study (mean age 60.3 ± 8; 52.4% female). 11,339 (74.2%) of the colonoscopies were performed by GI, and 3937 (25.7%) were by CRS. Withdrawal time and total scope time were shorter in the GI group. Cecal intubation rate was comparable. Overall ADR, female ADR and male ADR were significantly higher in the GI group, although both groups met national quality benchmarks.

CONCLUSION:

Both specialties achieve appropriate quality metrics for screening colonoscopy. Prospectively evaluating each endoscopist's outcomes, regardless of specialty, is an important tool for ongoing quality improvement towards better patient outcomes.

KEYWORDS:

Adenoma detection rate; Colonoscopy; Quality; Specialty

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