Colonoscopy quality in community hospitals and nonhospital facilities in Korea

Abstract

Background/Aims: High-quality colonoscopy is essential to reduce colorectal cancer-related deaths. Little is known about colonoscopy quality in non-academic practice settings. We aimed to evaluate the quality of colonoscopies performed in community hospitals and nonhospital facilities. Methods: Colonoscopy data were collected from patients referred to six tertiary care centers after receiving colonoscopies at community hospitals and nonhospital facilities. Based on their photographs, we measured quality indicators including cecal intubation rate, withdrawal time, adequacy of bowel preparation, and number of polyps. Results: Data from a total of 1,064 colonoscopies were analyzed. The overall cecal intubation rate was 93.1%. The median withdrawal time was 8.3 minutes, but 31.3% of colonoscopies were withdrawn within 6 minutes. Community hospitals had longer withdrawal time and more polyps than nonhospital facilities (median withdrawal time: 9.9 minutes vs. 7.5 minutes, p < 0.001; mean number of polyps: 3.1 vs. 2.3, p = 0.001). Board-certified endoscopists had a higher rate of cecal intubation than non-board-certified endoscopists (93.2% vs. 85.2%, p = 0.006). A total of 819 follow-up colonoscopies were performed at referral centers with a median interval of 28 days. In total, 2,546 polyps were detected at baseline, and 1,088 were newly identified (polyp miss rate, 29.9%). Multivariable analysis revealed that older age (odds ratio [OR], 1.032; 95% confidence interval [CI], 1.020 to 1.044) and male sex (OR, 1.719; 95% CI, 1.281 to 2.308) were associated with increased risk of missed polyps. Conclusions: The quality of colonoscopies performed in community hospitals and nonhospital facilities was suboptimal. Systematic reporting, auditing, and feedback are needed for quality improvement.

Development and status quo of digestive endoscopy in China: An analysis based on the national census in 2013 and 2020

“…For instance, overall cecal intubation rate of colonoscopy and complete examination rate of capsule endoscopy were 94.4% and 93.66% respectively, while 93.1% and 83.7% in Korea. [ 43 , 44 ] The success rate of selective deep cannulation during ERCP was 95.67%, and this rate was 93.1% in Sweden in the same year. [ 20 ] Besides, based on the previous results from 5-year consecutive nationwide surveys and multicenter prospective studies, [ 45 ] the success rate of extraction of common bile duct stones ( < 1 cm) and proportion of pancreatitis after ERCP were 94.2% and < 10% respectively.…”

Demographic and clinical profile of patients undergoing colonoscopy at a tertiary care center in Nepal: a retrospective cross-sectional study

“…We found that the mean age of the patients who underwent colonoscopy was 43.8 years, which is comparable to other similar studies done in Nepal 5 – 7 . However, the median age of patients undergoing colonoscopy was reported to be 62.5 years in a study done in the USA, 57 years in a general hospital in the UK and 59 years in a study done in South Korea 10 – 12 . In Nepal, the use of colonoscopy as a screening tool for colorectal carcinoma (CRC) in older individuals has not been widely established yet.…”

Strategies to improve screening colonoscopy quality for the prevention of colorectal cancer

“…Therefore, it is important to be familiar with quality indicators and continuously measure them in routine practice [ 72 , 73 ]. Studies have shown that the monitoring and reporting of colonoscopy quality indicators in Korea are suboptimal [ 74 , 75 ]. With the recent increase in CRC, the interest in and concerns about colonoscopy are also increasing.…”