Timed colonoscopy withdrawal, a mandatory quality measure in the era of national screening?

Abstract

A minimum recommended withdrawal time for screening colonoscopy is recommended for by both the US Multi-Society Task Force on Colorectal Cancer and European Society of Gastrointestinal Endoscopy. To characterize the relationship between endoscopists withdrawal time at colonoscopy and polyp detection in a symptomatic cohort of patients as compared to previously untimed withdrawal. Three experienced medical endoscopists prospectively performed 1079 colonoscopies during a 24-month period in an Irish hospital. Mean withdrawal time and individual polyp detection rate were noted. Introduction of mandatory withdrawal time which was monitored and documented was associated with higher polyp detection rate (33 versus 21%, p < 0.005) as compared to previously untimed withdrawal. Our findings support a monitored colonoscopy withdrawal time of at least 6min, which correlates with higher colon polyp detection rates in a symptomatic cohort.