Abstract
The delivery of the Scottish Bowel Screening Programme (SBoSP) is rooted in the provision of a high quality, effective and participant-centred service. Safe and effective colonoscopy forms an integral part of the process. Additional accreditation as part of a multi-faceted programme for participating colonoscopists, as in England, does not exist in Scotland. This study aimed to describe the quality of colonoscopy in the SBoSP and compare this to the English national screening standards. Data were collected from the SBoSP between 2007 and 2014. End-points for analysis were caecal intubation, cancer, polyp and adenoma detection, and complications. Overall results were compared with 2012 published English national standards for screening and outcomes from 2006 to 2009. During the study period 53 332 participants attended for colonoscopy. The colonoscopy completion rate was 95.6% overall. The mean cancer detection rate was 7.1%, the polyp detection rate was 45.7% and the adenoma detection rate was 35.5%. The overall complication rate was 0.47%. Colonoscopy quality in the SBoSP has exceeded the standard set for screening colonoscopy in England, despite not adopting a multi-faceted programme for screening colonoscopy. However, the overall adenoma detection rate in Scotland was 9.1% lower than that in England which has implications for colonoscopy quality and may have an impact on cancer prevention rates, a key aim of the SBoSP.
Highlights
Population-based colorectal cancer (CRC) screening using tests for the presence of occult blood in faeces leads to a reduction in disease-specific mortality [1,2,3]
Colonoscopy quality in the Scottish Bowel Screening Programme (SBoSP) has exceeded the standard set for screening colonoscopy in England, despite not adopting a multi-faceted programme for screening colonoscopy
What does this paper add to the literature? Our results demonstrate that, high standards of colonoscopy can be delivered within a national screening programme without the multifaceted approach adopted by the National Health Service Bowel Cancer Screening Programme, the adenoma detection rate within the Scottish Bowel Screening Programme is 9.1% less than the National Health Service Bowel Cancer Screening Programme
Summary
Population-based colorectal cancer (CRC) screening using tests for the presence of occult blood in faeces leads to a reduction in disease-specific mortality [1,2,3]. The provision of high quality colonoscopy within a screening programme is fundamental to achieving these aims and has been emphasized in recent studies and guidelines [4,5]. The adenoma detection rate (ADR) is a widely used indicator of colonoscopy quality; it is a marker of both the technical quality of the procedure and the efficacy of the screening strategy [6,7]. ADR is known to vary widely both between and within screening programmes [8,9,10,11]. Much of this variation may be explained by factors relating to the quality of the colonoscopy
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Schedule a callMore From: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
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