Variation in caecal intubation rates between screening and symptomatic patients

Nagrath, Nalin; Phull, Perminder

doi:10.1177/2050640614536898

Cited by 6 publications

(3 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With increasing pressure on endoscopy services to cope with implementation of CRC screening in several countries, different standards may develop formally or informally. Self-selection of endoscopists (informal recruitment) or setting higher standards for endoscopists allowed to perform colonoscopy screening (formal recruitment), may explain observed differences in CIR 8 , possibly giving a false impression that cecal intubation is harder to achieve in routine clinical colonoscopy of patients than in screening of presumptively healthy individuals. Therefore, it is of paramount importance in these times of screening implementation to follow time trends in the quality of clinical and screening endoscopy services and reduce the range of subjectivity in estimation of quality endpoints and of co-variables influencing on these endpoints.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, endoscopist characteristics were limited to level of experience and any organizational bias was not accounted for, e. g. the extent of allocating some endoscopists to certain groups of patients or screenees. The other was a smaller, single-center study comprising 1,056 colonoscopies from 5 endoscopists showing poorer CIR in routine clinics than screening colonoscopy 8 . In this study, all endoscopists were performing routine clinical and screening colonoscopies, but the study was restricted to 1 center and very few endoscopists.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cecum intubation rate as quality indicator in clinical versus screening colonoscopy

et al. 2017

View full text Add to dashboard Cite

Background and study aims Some guidelines recommend a minimum standard of 90 % cecal intubation rate (CIR) in routine clinics and 95 % in screening colonoscopy, while others have not made this distinction – both with limited evidence to support either view. This study questions the rationale for making such differentiation. Patients and methods We assessed cecum intubation rates amongst colonoscopies recorded in the Norwegian national quality register Gastronet by 35 endoscopists performing both clinical and screening colonoscopies. Colonoscopies were categorized into primary screening colonoscopy, work-up colonoscopy of screen-positives and clinical colonoscopy or surveillance. Cases with insufficient bowel preparation or mechanical obstruction were excluded. Endoscopists were categorized into “junior” and “senior” endoscopists depending on training and experience. Univariable and multivariable logistic regression analyses were applied. Results During a 2-year period, 10,267 colonoscopies were included (primary screening colonoscopy: 746; work-up colonoscopy of screen-positives: 2,604; clinical colonoscopy or surveillance: 6917). The crude CIR in clinical routine colonoscopy, primary screening colonoscopy and work-up colonoscopy was 97.1 %, 97.1 % and 98.6 %, respectively. In a multiple logistic regression analysis, there were no differences in CIR between the 3 groups. Poor bowel cleansing and female sex were independent predictors for intubation failure. Conclusion Cecal intubation rate in clinical colonoscopies and colonoscopy screening are similar. There is no reason to differentiate between screening and clinical colonoscopy with regard to CIR.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cecum intubation rate as quality indicator in clinical versus screening colonoscopy

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Screening colonoscopies performed by people other than gastroenterologists, are significantly more often associated with the appearance of interval CRC. The cecal intubation rate, a key quality performance indicator for colonoscopy, is lower in symptomatic patients compared with individuals undergoing CRC screening [40].…”

Section: Value Of Endoscopists' Training and Experiencementioning

confidence: 98%

Colonoscopy in Colorectal Cancer Screening: Current Aspects

Triantafillidis

Vagianos

Malgarinos

2015

Indian J Surg Oncol

View full text Add to dashboard Cite

Colonoscopy represents a very important diagnostic modality for screening for colorectal cancer, because it has the ability to both detect and effectively remove pro-malignant and malignant lesions. It is recommended by almost all international and national gastroenterology and cancer societies, as an initial screening modality or, following a positive fecal occult blood test, to be performed every 10 years in individuals of average risk starting from the age of 50. However, a significant problem is the so-called post-screening (interval) polyps and cancers found some years after the index colonoscopy. In order to reduce the rate of interval cancers it is extremely necessary to optimize the quality and effectiveness of colonoscopy. Bowel preparation is of paramount importance for both accurate diagnosis and subsequent treatment of lesions found on colonoscopy. The quality of bowel preparation could be significantly improved by splitting the dose regimens, a strategy that has been shown to be superior to single-dose regimen. A good endoscopic technique and optimal withdrawal time offering adequate time for inspection, would further optimize the rate of cecal intubation and the number of lesions detected. During the last years, sophisticated devices have been introduced that would further facilitate cecal intubation. The percentage of total colonoscopies is now super-passing the level of 95 % allowing the adenoma detection rate to be greater than the suggestive level of 25 % in men and 15 % in women. This review aims to provide the reader with the current knowledge concerning indications, usefulness, limitations and future perspectives of this probably most important screening technique for colorectal cancer available today.

show abstract