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Abstract
Colonoscopy is the ‘gold standard’ investigation of the colon. High quality colonoscopy is essential to diagnose early cancer and reduce its incidence through the detection and removal of pre-malignant adenomas. In this review, we discuss the key components of a high quality colonoscopy, review methods for improving quality, emerging technologies that have the potential to improve quality and highlight areas for future work.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
Key issues
A high quality colonoscopy must consist of a complete, thorough examination combined with good quality and safe therapeutics and the best possible patient experience.
Investment in training and quality assurance results in significant improvements in completion rates.
The link between adenoma detection rate and interval cancers means that emphasis must now be placed on reducing the variability in adenoma detection rate through improvement in colonoscopy technique and use of advanced imaging where appropriate.
Therapeutics must be performed safely and to the highest technical standard to maximize the potential of colonoscopy to reduce colorectal cancer incidence.
Continued emphasis on patient safety and experience is important.