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Colonoscopy Quality Critical Factor to Thorough Exam and Best Colon Cancer Detection
Date:1/13/2009

Flawed Analysis Misleading on Key Quality Indicators

BETHESDA, Md., Jan. 13 /PRNewswire-USNewswire/ -- Publication of a meta-analysis by Wilkins et al. on colonoscopy screening for colorectal cancer performed by primary care physicians raises several important issues regarding the quality of the exam, the safety of patients and the effectiveness of detecting colorectal cancer and pre-cancerous changes in the colon.

"The clinical evidence supports the College's position that the training and experience of the endoscopist are critical to a quality colonoscopy and cancer detection," explained Eamonn M.M. Quigley, M.D., FACG, President of the American College of Gastroenterology. "The College advises patients to seek a well-trained endoscopist who performs many of these tests and has a record of performing a complete examination of the colon. A patient undergoing a colonoscopy must be assured that their examination will truly be capable of detecting any and all abnormalities that could indicate disease or a predisposition to cancer. Otherwise, colon cancer will not be prevented."

"Any physician who performs colonoscopy needs to meet a high standard, and must be capable of interpreting all possible abnormalities seen, dealing with any therapeutic interventions that may arise, and managing the patient's safety," added Dr. Quigley.

The College believes that the findings of the Wilkins study are potentially misleading.

"This study is a meta-analysis of reports from selected centers reporting detection rates of adenomas and cancers in screening colonoscopies by primary care physicians. These data from selected centers are less generalizable than data obtained from population-based studies on detection rates of neoplasia," according to Douglas K. Rex, M.D., FACG, a representative of the ACG to the U.S. Multi-Society Task Force on Colorectal Cancer.

Available evidence
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SOURCE American College of Gastroenterology
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