You want a procedure that is Complete, Thorough, and Effective.
Complete
For colonoscopies, a complete exam is one in which the scope is progressed all the way to the cecum. The success rate in which a MD reaches the cecum is called the Cecal Intubation Rate. The national standard for Cecal Intubation is 90%. Gastroenterologists and Colo-Rectal Surgeons that are specially trained in endoscopy typically have much higher success rates of reaching the Cecum. In fact, the Gastrointestinal Endoscopy Center had an overall Cecal Intubation rate of 99.7% for 2015.
Thorough
After reaching the cecum, you want your endoscopist to spend quality time during the withdrawal examining the colon for polyps or other abnormalities. The total time after the cecum is reached to the time the scope is removed is called the Cecal Withdrawal Time. The national standard for the average Cecal Withdrawal is 6 minutes. Gastroenterologists and Colo-Rectal Surgeons are trained to take their time during withdrawal while not lingering in the colon too long leading to prolonged procedures and increasing complications from the extended sedation. The range for the average withdrawal time for the medical staff of the Gastrointestinal Endoscopy Center fell between 8 and a half minutes and 10 minutes for 2015.
Effective
In many ways, the purpose behind having a colonoscopy is to detect and remove growths in the colon known as polyps. Certain types of polyps have a greater risk of becoming forming cancer cells than others. These are known as adenomatous polyps or adenomas and positive confirmation of an adenoma can only be done by retaining the specimen and sending it for examination by a pathologist. Therefore, what might be the most important quality marker for colonoscopies is what is known as the Adenoma Detection Rate (ADR). This number is a percentage comparison that considers only patients who are having a screening colonoscopy and looks at the number of adenomatous polyps found and removed during those procedures. Studies have shown that men carry adenomatous polyps more frequently women and therefore the quality standard is different for each gender with the traditional target detection rate being 20% in females and 30% in males. Recent studies conducted by the American Gastroenterology Association (AGA) have concluded that for each percent of increase in ADR there is a corresponding decrease of interval colon cancer incidence of 3.4% and a decrease in colon cancer mortality rate of 4%. In 2015, the combined medical staff of the Gastrointestinal Endoscopy Center had an ADR of 33.5% for females and 45.9% for males.
Prior to having your colonoscopy, be sure to find out what your doctor’s quality scores are and how they compare to their peers. No one wants to have a colonoscopy, so if you have to have one, it only makes sense to ensure that your procedure is as complete, thorough and effective as possible!