Improvements in colonoscopy performance help prevent and treat colorectal cancer

Rosa Emilia Moraes, Scientific journalist at Linceu Editorial, São José dos Campos, SP, Brazil.

Colonoscopy is an exam for evaluating the colorectal mucosa through images, which allows the detection of anomalies such as polyps and lesions (LESLIE, et al, 2002). A well-performed colonoscopy is of great value in the prevention and diagnosis of colorectal cancer, representing a significant reduction in the risk of death for the patient.

However, despite being such an important health research tool, it is still not widely offered to the population in Brazil as part of disease prevention programs (SCHREUDERS, et al, 2015). Furthermore, studies evaluating the efficiency and quality of the intervention are scarce in the country and Latin America.

A clinical investigation conducted by researchers from the Faculdade de Medicina da Universidade de São Paulo (FMUSP) retrospectively analyzed data from colonoscopy procedures performed in eleven hospital units in seven cities in two Brazilian states from January to December 2021. The results are present in the article Quality indicators in colonoscopy: an observational study in a supplementary health system, published in the Acta Cirúrgica Brasileira (vol. 37, no. 11), where the authors analyze the quality indicators in the procedure related to several aspects such as the accuracy of the indication for the exam, the polyp detection rate, the cecal intubation rate, the quality of the patient’s colon preparation for the procedure, and the incidence of immediate adverse effects.

Image: Composition / Canva.

The research observed the correlation between the analyzed factors and the contribution of each one to the proficiency of the results. Among other observations, it was concluded that the structure of the place where the exam is performed, and the quality of medical care provided to the patient are variables that have a significant impact on the quality of the colonoscopy. In particular, the endoscopist’s level of technical knowledge and specialized training demonstrated a great influence on the polyp detection rates and the cecal intubation rate, which are determining factors in the evaluation.

The present study was carried out in a supplementary private health system in Brazil, a scenario where, in general, colonoscopies are safe procedures performed by trained physicians with good image-generating equipment. Even so, many opportunities were identified to improve the quality indicators in the participating hospitals, which demonstrates the relevance of a continuous evaluation that, it is hoped, will reflect in more effective exams and better prognoses in cases of colorectal cancer.

References

LESLIE, A., et al. The colorectal adenoma–carcinoma sequence. Br J Surg [online]. 2002, vol. 89, no. 7, pp. 845-860 [viewed 10 February 2023]. https://doi.org/10.1046/j.1365-2168.2002.02120.x. Available from: https://academic.oup.com/bjs/article/89/7/845/6150758

SCHREUDERS, E.H., et al. Colorectal cancer screening: a global overview of existing programmes. Gut [online]. 2015, vol. 64, no. 10, pp. 1637-1649 [viewed 10 February 2023]. https://doi.org/10.1136/gutjnl-2014-309086. Available from: https://gut.bmj.com/content/64/10/1637

To read the article, access

KUGA, R., FACANALI JUNIOR, M.R. and ARTIFON, E.L.A. Quality indicators in colonoscopy: observational study in a supplementary health system. Acta Cirúrgica Brasileira [online]. 2022, vol. 37, no. 11, e371106 [viewed 10 February 2023]. https://doi.org/10.1590/acb371106. Available from: https://www.scielo.br/j/acb/a/FqsSyzhyzZYPC3hcy8SG9yH/

External links

Acta Cirurgica Brasileira – ACB: https://www.scielo.br/acb/

Faculdade de Medicina da Universidade de São Paulo (FMUSP): https://www.fm.usp.br/

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