Audit on Colonoscopy Standards in a Tertiary Care Center in Kerala: An Interim Analysis

Background: Colorectal cancer (CRC) is a prevalent malignancy globally, but India exhibits a comparatively lower CRC prevalence. Early detection significantly impacts disease outcomes, with high-quality colonoscopy being the gold standard for CRC screening.

Methods: This retrospective audit scrutinized 439 patients who underwent colonoscopy at our center from August 2023 to January 2024. The study aimed to assess and analyze colonoscopy standards, encompassing bowel preparation, cecal intubation rate, polyp detection rate, and endoscopic characteristics of identified polyps. Demographics and indications for the procedure were also recorded.

Results: Among the 439 patients, 56% were above 50 years, while 35.3% were below 45 years. A majority (97.2%) followed a mixed diet. Bowel preparation was performed with split preparation in 18.3% of patients, while the rest received preparation on the same day. However, 95.9% achieved a Boston Bowel Preparation Score (BBPS) greater than 5, with no significant difference observed between split and same-day preparation. Cecal intubation was successful in 97% of patients. Polyps were detected in 28% of patients, with 76.9% having fewer than 3 polyps, and 48.7% of polyps being 5 mm or smaller and 29.2% polyps 1 cm or more in size. Right colon retroflexion, conducted in 6% of cases, showed no significant differences in polyp detection compared to routine double visualization of the right colon.

Conclusion: This study provides valuable insights into colonoscopy standards at our center. The high BBPS scores, successful cecal intubation, and effective polyp detection affirm the quality of colonoscopy in our cohort. The findings underscore the importance of adherence to screening guidelines. Further awareness and ongoing monitoring will contribute to refining CRC screening strategies and optimizing outcomes.

Publication History

Article published online:
22 April 2024