Quality control of colonoscopies in the National colorectal cancer screening program in the Czech Republic
Abstract
Objectives: The Czech Republic ranks the top position in world statistics in colorectal cancer (CRC) incidence and mortality. The quality of screening colonoscopy (SC) was evaluated based on two indicators – adenoma detection rate (ADR) and caecal intubation rate (CIR).
The aim of our analysis was to determine whether ADR and CIR of specific examiners correlate with the quantity of performed procedures and the way in which these results are described by individual colonoscopic screening centers. Methods: Data were analyzed from the colorectal cancer screening program in the CR.
Both, endoscopists and screening centers, were divided into five groups according to the number of patients examined. ADR and CIR of individual examiners and screening centers respectively were calculated.
Results: In 2010, 500 endoscopists in 185 screening centers performed a total of 17 876 screening colonoscopies. Average individual ADR and CIR was 33.6 % and CIR 95.1 % resp.
ADR correlates with the experience of colonoscopic specialists, however, in the group with the highest count of procedures, quality did not correlate with quantity. Individual CIR strongly correlates with experience, the group with more than 150 SC per year achieved 96 % CIR.
In the low volume centers (50 - 75 SC per year) ADR of 36.4 % was recorded. Conclusion: Our analysis shows that even smaller centers are able to maintain high standards of screening colonoscopies and no changes in minimum requirements for centers to participate are necessary.