The national colonoscopy audit: a nationwide assessment of the quality and safety of colonoscopy in the UK
- Daniel R Gavin1,2,
- Roland M Valori3,
- John T Anderson3,
- Mark T Donnelly4,
- J Graham Williams5,
- Edwin T Swarbrick6
- 1Cranfield Health, Cranfield University, Cranfield, UK
- 2Department of Gastroenterology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham General Hospital, Cheltenham, UK
- 3Department of Gastroenterology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
- 4Department of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield, UK
- 5Colorectal Surgery, The Royal Wolverhampton Hospitals NHS Foundation Trust, New Cross Hospital, Wolverhampton, UK
- 6The Royal Wolverhampton Hospitals NHS Foundation Trust, New Cross Hospital, Wolverhampton, UK
- Correspondence to Dr Daniel R Gavin, Research Fellow, Cranfield Health, Vincent Building (52a), Cranfield University, Cranfield, Bedfordshire MK43 0AL, UK;
Contributors DG, RV and ES were involved in study design, data gathering, data interpretation, writing and review of the manuscript. JA, MW and GW were involved in study design, interpretation of results and review of the manuscript.
- Revised 23 March 2012
- Accepted 25 March 2012
- Published Online First 1 June 2012
Objective To perform a comprehensive audit of all colonoscopy undertaken in the UK over a 2-week period.
Design Multi-centre survey. All adult (≥16 years of age) colonoscopies that took place in participating National Health Service hospitals between 28 February 2011 and 11 March 2011 were included.
Results Data on 20 085 colonoscopies and 2681 colonoscopists were collected from 302 units. A validation exercise indicated that data were collected on over 94% of all procedures performed nationally. The unadjusted caecal intubation rate (CIR) was 92.3%. When adjusted for impassable strictures and poor bowel preparation the CIR was 95.8%. The polyp detection rate was 32.1%. The polyp detection rate for larger polyps (≥10mm diameter) was 11.7%. 92.3% of resected polyps were retrieved. 90.2% of procedures achieved acceptable levels of patient comfort. A total of eight perforations and 52 significant haemorrhages were reported. Eight patients underwent surgery as a consequence of a complication.
Conclusions This is the first national audit of colonoscopy that has successfully captured the majority of adult colonoscopies performed across an entire nation during a defined time period. The data confirm that there has been a significant improvement in the performance of colonoscopy in the UK since the last study reported seven years ago (CIR 76.9%) and that performance is above the required national standards.
- colorectal cancer
- gastrointestinal endoscopy
- endoscopic procedures
- endoscopic polypectomy
- endoscopic retrograde pancreatography
- Crohn's disease
- colonic polyps
- inflammatory bowel disease
Funding The British Society of Gastroenterology and the Association of Coloproctologists of the United Kingdom and Ireland provided funding.
Correction notice This article has been corrected since it was published online First. The Abstract has been amended to read: All adult (≥16 years of age) colonoscopies that took place in participating National Health Service hospitals between 28 February 2011 and 11 March 2011 were included. The Discussion has been amended to read: Other series from institutions and programmes (including all the UK BCSPs) are able to report adenoma rates and so there is no reason why this should not be possible for every unit in the UK.15 ,31 ,41–44
Competing interests RV is a director of a medical quality improvement company, Quality Solutions for Healthcare (www.qsfh.co.uk).
Ethics approval This was an audit of current NHS colonoscopy practice. No patient or endoscopist identifying data were captured.
Provenance and peer review Not commissioned; externally peer reviewed.