Abstract
Background. Colonoscopy effectiveness depends on the quality of the examination. Community-based report of quality of colonoscopy practice in a developing country will help in determining standard and also serve as a stimulus for improvement in service. Aim. To review the quality of colonoscopy practice and document pattern of colonic disease including polyp detection rate in Lagos, Nigeria. Method. A protocol that captured the patients' demographics, indication, and some quality indices of colonoscopy was developed and sent to all the identified colonoscopy units in Lagos to complete for all procedures performed between January 2011 and June 2012. All data were collated and analyzed. The quality indices studied were compared with guideline standard. Results. Twelve colonoscopy centers were identified but only nine centers responded. The gastroenterologist/endoscopists were physicians (3) and surgeons (5). Six hundred and seven colonoscopy procedures were performed during this period (M : F = 333 : 179) while the sex was not disclosed in 95 subjects. The examination indications were lower GI bleeding (24.2%), altered bowel habits (9.2%), lower abdominal pain (9.1%), screening for CRC (4.3%) and unspecified (46.8%). Conscious sedation was generally used while bowel preparation (good in 81.4%) was done with low residue diet and stimulant laxatives. Caecal intubation rate was 81.2%. Common endoscopic findings were haemorrhoids (43.2%), polyps/masses (13.4%), diverticulosis (11.1%), and no abnormality (23.4%). Polyp was detected in 6.8% of cases. Conclusion. Colonoscopy utilization is low, and the quality of practice is suboptimal; although limited resources could partly explain this, however it is not clear if the low rate of polyp detection is due to missed lesions or low population incidence.
Highlights
Colorectal cancer (CRC) is a common malignancy especially in the Western countries and the third leading cause of cancer death [1]
Most interval colorectal cancer (CRC) occur because adenomas or actual CRC is missed during a colonoscopy
Aim The aim of this paper is to review the quality of practice of colonoscopy in Lagos, Nigeria, and document our pattern of colonic disease including polyp detection rate
Summary
Colorectal cancer (CRC) is a common malignancy especially in the Western countries and the third leading cause of cancer death [1]. Colonoscopy is the gold standard for colorectal cancer (CRC) screening [4]. Many quality indices have been studied to optimise endoscopy procedure from the perspective of both the patient and the physician, including caecal intubation rate, adenoma detection rate, withdrawal time and quality of colonoscopy reporting. Community-based report of quality of colonoscopy practice in a developing country will help in determining standard and serve as a stimulus for improvement in service. Aim. To review the quality of colonoscopy practice and document pattern of colonic disease including polyp detection rate in Lagos, Nigeria. Colonoscopy utilization is low, and the quality of practice is suboptimal; limited resources could partly explain this, it is not clear if the low rate of polyp detection is due to missed lesions or low population incidence
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