Introduction The Norwich Bowel Cancer Screening Centre was one of the initial pilot sites for launch of the Bowel Scope screening programme (BCSP) commencing in May 2014. Two key performance indicators of the Bowel Scope programme is the adenoma detection rate (ADR) and patient comfort scores. It has been shown previously that the depth of insertion correlates positively with the ADR.1 Speculation has been made that the use of paediatric and slim colonoscopes allow for deeper insertion, possibly due to better comfort scores. It has also been suggested that deeper insertion may lead to higher levels of reported discomfort.
Methods We have analysed data on BCSS from the last 2 years derived from the Norwich Screening Centre. In total 8 different types of endoscopes were used; Olympus 240, 260, 240 imager, 260 High definition, paediatric, superslim, Pentax colonoscopes and gastroscopes. A total of 4462 procedures were performed. The procedures were stratified by type of scope used and examined for depth of insertion and comfort scores.
Results Procedures terminated in the splenic flexure were associated with less discomfort when compared to those terminated in the descending colon and sigmoid (mild to moderate discomfort 5.3% splenic flexure, 13.1% descending colon, 37.6% sigmoid colon). This suggests that it is discomfort that prevents deep insertion rather than deep insertion causing discomfort.
Procedures using paediatric or superslim colonoscopes have higher reported rates of no discomfort when compared to standard colonoscopes (76.8% vs 65.8%, x2 =5.98, p = 0.05). Pentax gastroscopes were also reported as having better comfort scores when compared to Pentax colonoscopes (68.8% vs 63%) although this was not statistically significant, mainly due to the small numbers of procedures using gastroscopes.
Paediatric and super slim scopes are also associated with deeper insertion (42.4% to splenic flexure vs 32.8% in standard colonoscopes, x2 = 5.85, p = 0.05)
Conclusion Paediatric, Pentax gastroscopes and superslim endoscopes are associated with better comfort scores and deeper insertion. Therefore they should be used routinely on the Bowel Scope Screening Programme.
Reference 1 Warburton R, Meagher U, Tighe R. Bowel Scope Screening Programme: Depth of Insertion and Withdrawal Times vs Adenoma Detection Rate. Gut. 2015 June;64(Suppl 1):A411.1–A411
Disclosure of Interest None Declared