Efficacy and Effectiveness of Colonoscopy: How Do We Bridge the Gap?

David G. Hewett, Charles J. Kahi, Douglas K. Rex

Research output: Contribution to journalReview article

24 Scopus citations


Colonoscopy is sometimes considered the preferred colorectal cancer screening modality, yet this modality may be subject to variation in operator performance more than any other screening test. Failures of colonoscopy to consistently detect precancerous lesions threaten the effectiveness of this technique for the prevention of colorectal cancer. Studies on high-level adenoma detectors under optimal conditions have begun to establish the true efficacy of colonoscopy and further widen the gap between efficacy and effectiveness. Research is required to establish the component skills, attitudes, and behaviors for high-level mucosal inspection competence necessary for training and assessment. Interventions to bridge the gap between efficacy and effectiveness are lacking, yet they should emphasize quality measurement and operate at various levels within the health system to motivate change in endoscopist behavior.

Original languageEnglish (US)
Pages (from-to)673-684
Number of pages12
JournalGastrointestinal Endoscopy Clinics of North America
Issue number4
StatePublished - Oct 1 2010


  • Adenoma detection
  • Colonoscopy
  • Colorectal cancer
  • Effectiveness
  • Efficacy

ASJC Scopus subject areas

  • Gastroenterology

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