GI Unit Leadership: Optimizing Endoscopy Operations through Leadership (On-demand) | February 2025-ASGE ACG quality indicators

ASGE ACG quality indicators_colonoscopy

Pdf Summary

The document outlines updates on quality indicators for colonoscopy, emphasizing its central role in colorectal cancer (CRC) prevention. With colonoscopy as the preferred method for CRC screening and monitoring in the U.S., the evaluation addresses its impact on reducing CRC incidence and mortality, noting a stronger effect on left-sided compared to right-sided colon cancers.<br /><br />Key indicators for colonoscopy quality include the adenoma detection rate (ADR), sessile serrated lesion detection rate, adherence to recommended screening and surveillance intervals, bowel preparation adequacy, and cecal intubation rate. The ADR remains pivotal, with recommendations for it now accounting for procedures performed for both screening and some diagnostic purposes while excluding those following positive non-colonoscopy screening tests.<br /><br />The document emphasizes the variability in colonoscopy outcomes based on operator performance, necessitating organized efforts by gastroenterology and endoscopy societies to enhance procedural quality. This update reflects findings since 2015, underscoring the importance of adequate bowel preparation and colonoscopic techniques to ensure the effective identification and resection of precancerous lesions.<br /><br />It outlines methodological improvements, such as longer withdrawal times during the procedure to enhance adenoma detection, and cold snare polypectomy as a safer alternative to hot snaring for small lesions. Different scoring systems for inflammatory bowel disease (IBD) management during colonoscopy, such as the Mayo Endoscopic Score for ulcerative colitis and the Simple Endoscopic Activity Score for Crohn’s Disease, are provided to help categorize disease severity and tailor treatment strategies accordingly.<br /><br />The report advocates programmatic efforts for quality assurance, including individual performance feedback, reinforced by educational initiatives and advanced imaging technologies. It highlights the ethical imperative of adhering to recommended surveillance intervals post-colonoscopy to optimize CRC prevention and cost-effectiveness while also discussing the incidence and management of colonoscopy-associated adverse events like perforation and bleeding.

Keywords

colonoscopy

colorectal cancer prevention

adenoma detection rate

screening intervals

bowel preparation

cecal intubation rate

operator performance

quality assurance

adenoma detection

adverse events