Effectiveness, training and quality assurance of colonoscopy screening for colorectal cancer

被引:59
作者
Robertson, Douglas J. [1 ,2 ]
Kaminski, Michal F. [3 ,4 ,5 ]
Bretthauer, Michael [6 ]
机构
[1] VA Med Ctr, White River Jct, VT 05009 USA
[2] Geisel Sch Med Dartmouth, Hanover, NH USA
[3] Med Ctr Postgrad Educ, Dept Gastroenterol & Hepatol, Warsaw, Poland
[4] Maria Sklodowska Curie Mem Canc Ctr & Inst Oncol, Warsaw, Poland
[5] Univ Oslo, Inst Hlth & Soc, Oslo, Norway
[6] Oslo Univ Hosp, Dept Transplantat Med, Oslo, Norway
关键词
SCREENING; CANCER PREVENTION; COLONOSCOPY; COLORECTAL CANCER; SOCIETY TASK-FORCE; CLOSED MALPRACTICE CLAIMS; ADENOMA DETECTION RATE; EUROPEAN-SOCIETY; PATIENT EXPERIENCES; SURGICAL ERRORS; ENDOSCOPY; SKILLS; SURVEILLANCE; POLYPECTOMY;
D O I
10.1136/gutjnl-2014-308076
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Screening for colorectal cancer has been proven to be effective in reducing colorectal cancer incidence and mortality. While the precise benefit of screening exclusively by colonoscopy is not yet known, unarguably, the exam is central to the success of any screening programme. The test affords the opportunity to detect and resect neoplasia across the entire large bowel and is the definitive examination when other screening tests are positive. However, colonoscopy is invasive and often requires sedation as well as extensive bowel preparation, all of which puts the patient at risk. Furthermore, the test can technically be demanding and, unarguably, there is variation in how it is performed. This variation in performance has now been definitively linked to important outcome measures. For example, interval cancers are more common in low adenoma detectors as compared with high adenoma detectors. This review outlines the most current thinking regarding the effectiveness of colonoscopy as a screening tool. It also outlines key concepts to optimise its performance through robust quality assurance programmes and high-quality training.
引用
收藏
页码:982 / 990
页数:9
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