Quality Metrics and Indicators in Colonoscopy

Abstract

Colonoscopy is the preferred method for colorectal cancer screening. However, despite significant advances, the examination remainssubject to limitations and variability amongst different practitioners. This calls for the need for objective quality indicators toensure the optimal use of the modality. Three major priority quality measures have been identified that include adenoma detectionrate (ADR), cecal intubation, and adherence to surveillance guidelines. ADR is the best-studied metric correlating with outcomesincluding post-colonoscopy colon cancer, but has inherent limitations such as the potential for corruptibility. Other importantquality indicators include the quality of bowel preparation and colonoscopy withdrawal time. All these quality measures are interrelatedand an improvement in any of them would help in increasing the power of colonoscopy as a screening tool, as well asdecreasing its economic burden and potentially improving adherence to screening guidelines.

Keywords

• colonoscopy
• quality indicator
• quality metrics
• quality
• screening
• colorectal cancer
• polyps