title: Optimizing Colonoscopy Quality: From Bowel Preparation to Surveillance.
abstract: Colonoscopy is a powerful screening method for colorectal cancer. However, colonoscopy performance is highly variable and quality indicators are needed to ensure delivery of high-quality healthcare. A multi-society task force has recently identified three priority quality indicators in colonoscopy: adenoma detection rate, cecal intubation rate, and adherence to surveillance guidelines. The best-studied quality indicator is the adenoma detection rate, which is inversely correlated to the risk of interval colorectal cancer. Other important quality determinants include colonoscopy withdrawal time and the bowel preparation quality. It is important to note that these quality metrics are interrelated and optimization at every level is necessary for any high-quality colorectal cancer screening and prevention program.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, P.O. Box 11-0236/16-B, Beirut, Lebanon.
authors.forename: Carla G
authors.initials: CG
authors.lastname: Abou Fadel
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, P.O. Box 11-0236/16-B, Beirut, Lebanon.
authors.forename: Rani H
authors.initials: RH
authors.lastname: Shayto
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, P.O. Box 11-0236/16-B, Beirut, Lebanon. ala.sharara@aub.edu.lb.
authors.forename: Ala I
authors.initials: AI
authors.lastname: Sharara
keywords: Adenoma; Colon; Colorectal cancer; Endoscopy; Indicators; Screening
references.citation: World J Gastroenterol. 2015 Feb 14;21(6):1938-44
references.pmid: 25684963
references.citation: Gastrointest Endosc. 2000 Jan;51(1):33-6
references.pmid: 10625792
references.citation: Clin Transl Gastroenterol. 2015 Feb 26;6:e77
references.pmid: 25716302
references.citation: Gastrointest Endosc. 2014 Aug;80(2):277-83
references.pmid: 24629419
references.citation: Am J Gastroenterol. 2002 Jul;97(7):1696-700
references.pmid: 12135020
references.citation: Scand J Gastroenterol. 2014 Feb;49(2):222-37
references.pmid: 24328858
references.citation: Gut. 2012 Jul;61(7):1050-7
references.pmid: 21940723
references.citation: Gastrointest Endosc. 2013 Sep;78(3):510-6
references.pmid: 23642491
references.citation: Gut. 2014 Jan;63(1):125-30
references.pmid: 23503044
references.citation: Gastrointest Endosc. 2015 Jan;81(1):31-53
references.pmid: 25480100
references.citation: Gastroenterology. 2011 Jan;140(1):65-72
references.pmid: 20854818
references.citation: Am J Gastroenterol. 2015 Apr;110(4):543-52
references.pmid: 25756240
references.citation: Am J Gastroenterol. 2013 Feb;108(2):219-26; quiz 227
references.pmid: 23295274
references.citation: JAMA. 2015 Jun 16;313(23):2349-58
references.pmid: 26080339
references.citation: Ann Intern Med. 2009 Jan 6;150(1):1-8
references.pmid: 19075198
references.citation: Gastrointest Endosc. 2013 Mar;77(3):376-80
references.pmid: 23211748
references.citation: Am J Gastroenterol. 2006 Apr;101(4):873-85
references.pmid: 16635231
references.citation: Clin Gastroenterol Hepatol. 2014 Dec;12(12):1973-80
references.pmid: 24095973
references.citation: Am J Gastroenterol. 2014 Mar;109(3):417-26
references.pmid: 24394752
references.citation: Clin Gastroenterol Hepatol. 2008 Oct;6(10):1117-21; quiz 1064
references.pmid: 18691942
references.citation: Clin Gastroenterol Hepatol. 2014 Jul;12(7):1119-26
references.pmid: 24333512
references.citation: Gastroenterol Rep (Oxf). 2016 May;4(2):148-53
references.pmid: 25680361
references.citation: Gastrointest Endosc. 2015 Oct;82(4):668-75
references.pmid: 26385275
references.citation: Gastroenterology. 2008 Dec;135(6):1892-8
references.pmid: 18835390
references.citation: Gastrointest Endosc. 2013 Jan;77(1):71-8
references.pmid: 23261096
references.citation: Gastroenterol Clin North Am. 2013 Sep;42(3):599-618
references.pmid: 23931862
references.citation: Gastrointest Endosc. 2005 Aug;62(2):213-8
references.pmid: 16046981
references.citation: Endoscopy. 2012 May;44(5):476-81
references.pmid: 22531983
references.citation: World J Gastrointest Endosc. 2015 Aug 10;7(10):969-80
references.pmid: 26265990
references.citation: Gastrointest Endosc. 2015 Sep;82(3):488-94
references.pmid: 25910661
references.citation: Gastroenterology. 2012 Sep;143(3):844-857
references.pmid: 22763141
references.citation: Gastroenterology. 2015 Oct;149(4):938-51
references.pmid: 26122143
references.citation: J Interv Gastroenterol. 2011 Apr;1(2):53-58
references.pmid: 21776426
references.citation: PLoS One. 2014 Dec 03;9(12):e114267
references.pmid: 25470133
references.citation: Am J Gastroenterol. 2009 Mar;104(3):739-50
references.pmid: 19240699
references.citation: Dig Liver Dis. 2015 Jun;47(6):508-11
references.pmid: 25659823
references.citation: Gastrointest Endosc. 2015 Sep;82(3):520-2
references.pmid: 26279351
references.citation: Gastrointest Endosc. 2012 Sep;76(3):603-8.e1
references.pmid: 22732876
references.citation: Gastrointest Endosc. 2010 Apr;71(4):782-6
references.pmid: 20363418
references.citation: Endoscopy. 2008 Apr;40(4):284-90
references.pmid: 18389446
references.citation: Dig Endosc. 2015 Jul;27(5):590-5
references.pmid: 25708251
references.citation: Gastrointest Endosc. 2013 Jun;77(6):925-31
references.pmid: 23472996
references.citation: Dig Liver Dis. 2015 Jun;47(6):441-2
references.pmid: 25921276
references.citation: Gastrointest Endosc. 2011 Jul;74(1):128-34
references.pmid: 21531410
references.citation: Am J Gastroenterol. 2012 Aug;107(8):1165-73
references.pmid: 22664471
references.citation: Gastrointest Endosc. 2011 Aug;74(2):246-52
references.pmid: 21679946
references.citation: Gastrointest Endosc. 2011 Mar;73(3):456-63
references.pmid: 20950801
references.citation: Gut. 2013 Feb;62(2):236-41
references.pmid: 22442161
references.citation: Gastrointest Endosc. 2013 Dec;78(6):886-91
references.pmid: 23769143
references.citation: Gastrointest Endosc. 2012 Mar;75(3):515-20
references.pmid: 22018551
references.citation: Gastrointest Endosc. 2003 Jul;58(1):76-9
references.pmid: 12838225
references.citation: Am J Gastroenterol. 2015 Mar;110(3):415-22
references.pmid: 25732415
references.citation: Gastrointest Endosc. 2015 Oct;82(4):676-82
references.pmid: 26385276
references.citation: J Natl Cancer Inst. 2010 Jan 20;102(2):89-95
references.pmid: 20042716
references.citation: World J Gastroenterol. 2014 Dec 21;20(47):17709-26
references.pmid: 25548470
references.citation: Gastroenterol Clin North Am. 2013 Sep;42(3):577-98
references.pmid: 23931861
references.citation: Gastrointest Endosc. 2015 Sep;82(3):512-9
references.pmid: 25910665
references.citation: Gastrointest Endosc. 2015 Nov;82(5):887-94
references.pmid: 25952092
references.citation: Gastrointest Endosc. 2011 Jun;73(6):1207-14
references.pmid: 21481857
references.citation: Am J Gastroenterol. 2014 Feb;109(2):148-54
references.pmid: 24496417
references.citation: Gastrointest Endosc. 2015 Oct;82(4):683-5
references.pmid: 26385277
references.citation: Am J Gastroenterol. 2014 Nov;109(11):1714-23; quiz 1724
references.pmid: 25135006
references.citation: Gastrointest Endosc. 2015 Sep;82(3):495-6
references.pmid: 26279350
references.citation: Gastroenterology. 2015 Oct;149(4):952-7
references.pmid: 26164494
references.citation: Gastrointest Endosc. 2014 Apr;79(4):551-7
references.pmid: 24630082
references.citation: Gastrointest Endosc. 2014 Sep;80(3):463-70
references.pmid: 24818550
references.citation: N Engl J Med. 2014 Apr 3;370(14):1298-306
references.pmid: 24693890
references.citation: Gastroenterology. 1997 Jan;112(1):24-8
references.pmid: 8978338
references.citation: Gastrointest Endosc. 2011 Dec;74(6):1325-36
references.pmid: 21958899
references.citation: Am J Gastroenterol. 2002 Jun;97(6):1296-308
references.pmid: 12094842
references.citation: Gastrointest Endosc. 2011 Sep;74(3):656-65
references.pmid: 21741643
references.citation: Am J Gastroenterol. 2015 Aug;110(8):1134-9
references.pmid: 25869388
references.citation: Gut Liver. 2014 Nov;8(6):582-9
references.pmid: 25368744
references.citation: J Am Med Inform Assoc. 2016 Mar;23 (2):402-6
references.pmid: 26254481
references.citation: Am J Gastroenterol. 2014 Oct;109(10):1528-45
references.pmid: 25223578
references.citation: N Engl J Med. 2006 Dec 14;355(24):2533-41
references.pmid: 17167136