Journal: Gut and liver
This review emphasizes the critical role of high-quality colonoscopy in colorectal cancer (CRC) screening to reduce CRC incidence and mortality.
Key quality indicators include:
- Bowel preparation
- Cecal intubation
- Withdrawal time
These indicators strongly correlate with adenoma detection rate (ADR) and the risk of post-colonoscopy CRC (PCCRC).
The ADR is highlighted as the primary quality metric and predictor of PCCRC.
Increasing detection of serrated polyps, which cause 15-30% of CRC cases, is also crucial for reducing PCCRC risk.
Strategies to improve colonoscopy quality include:
- Systemic interventions
- Endoscopist audits and feedback
- Enhanced inspection techniques
- Advanced technologies such as mucosal exposure devices and computer-aided detection
While artificial intelligence shows promise for improving ADR, maintaining consistent high-quality technique remains essential for optimal CRC prevention.