Introduction Colonoscopies undertaken as part of the NHS Bowel Cancer Screening Programme (BCSP) must be of high standard in order to meet the Global Rating Scale (GRS) criteria. The same practitioners usually also provide a non-screening colonoscopy service. We aim to compare colonoscopy techniques and outcomes between screening and non-screening groups, in order to ascertain whether there are any areas for development, education, and service improvement.
Method Patient details were obtained for all consecutive colonoscopies between 2007 and 2014 performed by a single Consultant Surgeon at our NHS Trust. Data were collected retrospectively from electronic patient records, and screening (BCSP) and non-screening colonoscopies were compared. Data included patient demographics (age, gender), and colonoscopy performance (caecal intubation and neoplasia detection rates).
Results There were 1961 colonoscopies in this time period (1067 screening and 894 non screening). 1120/1961 (57%) were male. Mean (SD) age for all patients was 64 (±10.4) years. Non-screening patients were younger, had a wider variation in age (62 (±14) versus 66 (±4.8) years; p < 0.001), and were less likely to be male (51.5%vs.61.9%; p < 0.001) than their screening counterparts. Caecal intubation was more successful in screening patients (1027/1067 (96.3%)) than non-screening patients (805/894 (90%)); p < 0.001. There was no difference in neoplasia detection rate between the groups. Polypectomy was more likely (55.5% vs30.2%), and polyp retrieval more successful (97.5% vs.86.7%) in the screening group.
Conclusion Screening and non-screening colonoscopy patients differ in their performance factors, pathology detection and management, as well as patient demographics. Benchmarking non-screening colonoscopies against the high quality of screening colonoscopy may aid practitioners to optimise their own practice.
Disclosure of interest None Declared.
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