Abstract

EMURA, Fabian; CARR-LOCKE, David  and  SANTACOLOMA, Mario. Colonoscopy: its reason, indication and measurement of quality indicators. Just when a study reported that is not as good as it seems to be!. Rev Col Gastroenterol [online]. 2009, vol.24, n.1, pp.51-59. ISSN 0120-9957.

Colonoscopy was, is and probably will be the most reliable and effective method not only for to remove adenomatous polyps but also to diagnose and treat early stage colorectal cancer (CRC). A recent study, however, reported weaknesses of the test proposing that the relation between colonoscopy and CRC is primary limited to a reduction the left-side CRC related deaths. This review focuses on current scientific evidence regarding three fundamental aspects of colonoscopy: rationale, indications and measurements of quality indicators. In the context of CRC, screening colonoscopy identifies individuals who are more likely to have CRC or adenomatous polyps from among those without signs or symptoms of the disease. Approved indications for a screening test are well known. As for CRC, colonoscopy largely fulfills all of these criteria. Current accepted indications for recommending a colonoscopy are described in this review. The list was elaborated based on the published literature and the expert’s opinions. Quality indicators in colonoscopy are required for ensuring that small CRC are not overlooked, especially right-sided small CRC. These indicators are published and accepted worldwide. Their usefulness is largely based on establishing competence of gastroenterologist performing colonoscopy and measuring the effectiveness of each procedure. This review has studied five of the most important quality indicators in colonoscopy: cecal intubation, cecal photography, detection of adenomatous polyps, withdrawal time and bowel preparation. CRC is treatable and beatable when diagnosed in early stage. To reach this goal, colonoscopy is currently the most effective and reliable method for prevention and early detection of the disease.

Keywords : Colonoscopy; quality indicators; colorectal cancer; screening; polyps.

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