Masterclass: Colorectal Screening Plus (Virtual) | September 2025-Owings_Masterclass_In the Endo

Owings_Masterclass_In the Endo_Real World Colonoscopy Cases

Pdf Summary

This educational content by Dr. Anna H. Owings focuses on real-world colonoscopy cases for colorectal cancer (CRC) screening, emphasizing quality metrics, clinical decision-making, and emerging trends. Key colonoscopy quality metrics include the Boston Bowel Preparation Scale (BBPS), cecal intubation rate, and adenoma detection rate (ADR). The BBPS measures bowel preparation adequacy on a scale of 0-3 in each colon segment; a combined score of 6 or more with no segment under 2 indicates satisfactory preparation, allowing standard screening intervals. Cecal intubation requires photographic evidence of landmarks with a goal rate of 95%. ADR benchmarks are 35% overall (40% men, 30% women), with an average withdrawal time of eight minutes recommended.<br /><br />Cases illustrate application of guidelines: <br /><br />- Case 1 discusses appropriate screening intervals after a colonoscopy with severe diverticular disease but no polyps; recommendations vary from one to ten years based on risk.<br /><br />- Case 2 covers a patient with positive Cologuard following adenoma detection, highlighting that Cologuard is inappropriate for non-average-risk patients with prior adenomas.<br /><br />- Case 3 addresses incomplete colonoscopy due to tortuous anatomy and suggests alternatives like referral to an advanced endoscopist, repeat colonoscopy with modifications, CT colonography, or capsule endoscopy.<br /><br />- Case 4 highlights early screening initiation in a young patient with multiple relatives diagnosed with CRC, based on family history and guidelines recommending starting 10 years before youngest diagnosis.<br /><br />- Case 5 focuses on screening in elderly patients (75+), weighing risks versus benefits and surveillance intervals after polypectomy, stressing polyp size, morphology, and appropriate tattoo placement for future identification.<br /><br />- Case 6 deals with screening timing for a young patient with ulcerative colitis and family history, emphasizing the need for earlier, annual chromoendoscopy surveillance.<br /><br />Overall, the course underlines personalized, evidence-based CRC screening, using standardized quality measures and adapting to patient-specific risks to optimize outcomes.

Keywords

colonoscopy

colorectal cancer screening

Boston Bowel Preparation Scale

adenoma detection rate

cecal intubation rate

diverticular disease

Cologuard

incomplete colonoscopy

family history colorectal cancer

ulcerative colitis surveillance