Inadequate Boston Bowel Preparation Scale scores predict the risk of missed neoplasia on the next colonoscopy

Colorectal cancer (CRC) is among the most commonly diagnosed cancers and causes of death from cancer across the world. CRC can, however, be detected in asymptomatic patients at a curable stage, and several studies have shown lower mortality among patients who undergo screening compared with those who do not. Using colonoscopy in CRC screening also results in the detection of precancerous polyps that can be directly removed during the procedure, thereby reducing the incidence of cancer. In the past decade, convincing evidence has appeared that the effectiveness of colonoscopy as CRC prevention tool is associated with the quality of the procedure. This review aims to provide an up-to-date overview of recent efforts to improve colonoscopy effectiveness by enhancing detection and improving the completeness and safety of resection of colorectal lesions.

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“…Consistent with this conclusion, segmental scores of ≥ 2 predict a lower risk of polyps in that segment at follow up colonoscopy 36 .…”

Section: Accepted Manuscriptsupporting

confidence: 63%

Advances in CRC Prevention: Screening and Surveillance

2018

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“…Based on these findings, the investigators suggested that a total BBPS score of ≥ 6 and/or all segment scores ≥ 2 may serve as a standard definition of “adequate for 10-year follow-up”[ 44 ]. However, a prospective, observational study in a large, national endoscopic consortium found that inadequate single BBPS segment scores at the initial, average-risk screening colonoscopy were correlated with significantly greater risk of polyps at a second colonoscopy, suggesting that both a total score of ≥ 6 and all segment scores ≥ 2 should be required as an adequacy standard for 10-year follow-up[ 56 ]. This assessment was affirmed by a study in 438 colonoscopies in men, which found that BBPS segment scores of 2 or 3 (with 2 being noninferior to 3) was indicative of adequate bowel preparation for detection of adenomas > 5 mm, and for repeat colonoscopy at standard, guideline-recommended intervals (both parameters are USMSTFCC-recommended criteria for bowel preparation adequacy)[ 11 , 57 ].…”

Section: Validated Bowel Preparation Scalesmentioning

confidence: 99%

Bowel preparation quality scales for colonoscopy

Kastenberg

Bertiger

Brogadir

2018

WJG

158

144

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Colorectal cancer (CRC) is the third most common cancer and second leading cause of cancer-related death in the United States. Colonoscopy is widely preferred for CRC screening and is the most commonly used method in the United States. Adequate bowel preparation is essential for successful colonoscopy CRC screening. However, up to one-quarter of colonoscopies are associated with inadequate bowel preparation, which may result in reduced polyp and adenoma detection rates, unsuccessful screens, and an increased likelihood of repeat procedure. In addition, standardized criteria and assessment scales for bowel preparation quality are lacking. While several bowel preparation quality scales are referred to in the literature, these differ greatly in grading methodology and categorization criteria. Published reliability and validity data are available for five bowel preparation quality assessment scales, which vary in several key attributes. However, clinicians and researchers continue to use a variety of bowel preparation quality measures, including nonvalidated scales, leading to potential confusion and difficulty when comparing quality results among clinicians and across clinical trials. Optimal clinical criteria for bowel preparation quality remain controversial. The use of validated bowel preparation quality scales with stringent but simple scoring criteria would help clarify clinical trial data as well as the performance of colonoscopy in clinical practice related to quality measurements.

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“…BBPS scores correlates with polyp detection rates and caecal intubation time 5,8. Lower BBPS score is associated with missed polyp detection and requires early repeat colonoscopy as it has negative impact on colon cancer prevention 6,9…”

Section: Introductionmentioning

confidence: 99%

Impact of bowel preparation on caecal intubation time during colonoscopy

et al. 2019

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Objective: To determine the caecal intubation time depending on bowel preparation as per Boston Bowel Preparation Scale. Methods: This cross-sectional study was conducted at Dr. Ruth K. M. Pfau, Civil Hospital Karachi between August 2018 to February 2019. A total of 201 patients were included in the study. Time was recorded from insertion of colonoscope to the time required to reach the cecum. Bowel preparation was graded during withdrawal of colonoscope by using Boston Bowel Preparation Scale. Pearson Correlation test was used to study correlation of BBPS scores with CIT, gender, BMI, adenoma and polyp detection. Results: In this study 201 patients undergoing colonoscopy were included. Mean ±SD of age of patients was 36.9 ±15.8 years. Out of the 201 patients 112 (56%) were males and 89 (44%) were females. The results of our study showed that increased Boston Bowel Preparation Scale Scores were associated with decreased caecal intubation time. The mean CIT was 10.7 ±5.4 minutes and Pearson correlation was significant at 0.002. Significant correlations of BBPS were also found with BMI and adenoma detection. Conclusion: The diagnostic effectiveness of colonoscopy depends upon the quality of the preparation. Good bowel preparation improves the speed of colonoscopy and its completeness. doi: https://doi.org/10.12669/pjms.35.6.1031 How to cite this:Alvi H, Rasheed T, Shaikh MA, Ali FS, Zuberi BF, Samejo AA. Impact of bowel preparation on caecal intubation time during colonoscopy. Pak J Med Sci. 2019;35(6):1516-1519. doi: https://doi.org/10.12669/pjms.35.6.1031 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Inadequate Boston Bowel Preparation Scale scores predict the risk of missed neoplasia on the next colonoscopy

Cited by 71 publications

References 26 publications

Advances in CRC Prevention: Screening and Surveillance

Advances in CRC Prevention: Screening and Surveillance

Bowel preparation quality scales for colonoscopy

Impact of bowel preparation on caecal intubation time during colonoscopy

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