Quality of colonoscopy in an organised colorectal cancer screening programme with immunochemical faecal occult blood test: The EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy)

Manuel Zorzi, Carlo Senore, Filippo Da Re, Alessandra Barca, Luigina Ada Bonelli, Renato Cannizzaro, Renato Fasoli, Lucia Di Furia, Emilio Di Giulio, Paola Mantellini, Carlo Naldoni, Romano Sassatelli, Douglas Rex, Cesare Hassan, Marco Zappa

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Objectives: To assess variation in the main colonoscopy quality indicators in organised colorectal cancer (CRC) screening programmes based on faecal immunochemical test (FIT). Design: Data from a case-series of colonoscopies of FIT-positive subjects were provided by 44 Italian CRC screening programmes. Data on screening history, endoscopic procedure and histology results, and additional information on the endoscopy centre and the endoscopists were collected. The adenoma detection rate (ADR) and caecal intubation rate (CIR) were assessed for the whole population and the individual endoscopists. To explore variation in the quality indicators, multilevel analyses were performed according to patient/centre/endoscopist characteristics. Results: We analysed 75 569 (mean age: 61.3 years; men: 57%) colonoscopies for positive FIT performed by 479 endoscopists in 79 centres. ADR ranged from 13.5% to 75% among endoscopists (mean: 44.8%). ADR was associated with gastroenterology specialty (OR: 0.87 for others, 95% CI 0.76 to 0.96) and, at the endoscopy centre level, with the routine use of sedation (OR: 0.80 if occasional (600 colonoscopies; 95% CI 1.11 to 2.04) and, at the endoscopy centre level, screeningdedicated sessions (OR: 2.18; 95% CI 1.24 to 3.83) and higher rates of sedation (OR: 0.47 if occasional; 95% CI 0.24 to 0.92). Conclusions: The quality of colonoscopy was affected by patient-related, endoscopist-related and centre-related characteristics. Policies addressing organisational issues should improve the quality of colonoscopy in our programme and similar programmes.

Original languageEnglish (US)
Pages (from-to)1389-1396
Number of pages8
JournalGut
Volume64
Issue number9
DOIs
StatePublished - Sep 1 2015

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Occult Blood
Hematologic Tests
Colonoscopy
Early Detection of Cancer
Endoscopy
Colorectal Neoplasms
Adenoma
Organizational Policy
Multilevel Analysis
Gastroenterology
Intubation
Histology
History
Population

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)

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Quality of colonoscopy in an organised colorectal cancer screening programme with immunochemical faecal occult blood test : The EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy). / Zorzi, Manuel; Senore, Carlo; Da Re, Filippo; Barca, Alessandra; Bonelli, Luigina Ada; Cannizzaro, Renato; Fasoli, Renato; Furia, Lucia Di; Giulio, Emilio Di; Mantellini, Paola; Naldoni, Carlo; Sassatelli, Romano; Rex, Douglas; Hassan, Cesare; Zappa, Marco.

In: Gut, Vol. 64, No. 9, 01.09.2015, p. 1389-1396.

Research output: Contribution to journalArticle

Zorzi, M, Senore, C, Da Re, F, Barca, A, Bonelli, LA, Cannizzaro, R, Fasoli, R, Furia, LD, Giulio, ED, Mantellini, P, Naldoni, C, Sassatelli, R, Rex, D, Hassan, C & Zappa, M 2015, 'Quality of colonoscopy in an organised colorectal cancer screening programme with immunochemical faecal occult blood test: The EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy)', Gut, vol. 64, no. 9, pp. 1389-1396. https://doi.org/10.1136/gutjnl-2014-307954
Zorzi, Manuel ; Senore, Carlo ; Da Re, Filippo ; Barca, Alessandra ; Bonelli, Luigina Ada ; Cannizzaro, Renato ; Fasoli, Renato ; Furia, Lucia Di ; Giulio, Emilio Di ; Mantellini, Paola ; Naldoni, Carlo ; Sassatelli, Romano ; Rex, Douglas ; Hassan, Cesare ; Zappa, Marco. / Quality of colonoscopy in an organised colorectal cancer screening programme with immunochemical faecal occult blood test : The EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy). In: Gut. 2015 ; Vol. 64, No. 9. pp. 1389-1396.
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abstract = "Objectives: To assess variation in the main colonoscopy quality indicators in organised colorectal cancer (CRC) screening programmes based on faecal immunochemical test (FIT). Design: Data from a case-series of colonoscopies of FIT-positive subjects were provided by 44 Italian CRC screening programmes. Data on screening history, endoscopic procedure and histology results, and additional information on the endoscopy centre and the endoscopists were collected. The adenoma detection rate (ADR) and caecal intubation rate (CIR) were assessed for the whole population and the individual endoscopists. To explore variation in the quality indicators, multilevel analyses were performed according to patient/centre/endoscopist characteristics. Results: We analysed 75 569 (mean age: 61.3 years; men: 57{\%}) colonoscopies for positive FIT performed by 479 endoscopists in 79 centres. ADR ranged from 13.5{\%} to 75{\%} among endoscopists (mean: 44.8{\%}). ADR was associated with gastroenterology specialty (OR: 0.87 for others, 95{\%} CI 0.76 to 0.96) and, at the endoscopy centre level, with the routine use of sedation (OR: 0.80 if occasional (600 colonoscopies; 95{\%} CI 1.11 to 2.04) and, at the endoscopy centre level, screeningdedicated sessions (OR: 2.18; 95{\%} CI 1.24 to 3.83) and higher rates of sedation (OR: 0.47 if occasional; 95{\%} CI 0.24 to 0.92). Conclusions: The quality of colonoscopy was affected by patient-related, endoscopist-related and centre-related characteristics. Policies addressing organisational issues should improve the quality of colonoscopy in our programme and similar programmes.",
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T1 - Quality of colonoscopy in an organised colorectal cancer screening programme with immunochemical faecal occult blood test

T2 - The EQuIPE study (Evaluating Quality Indicators of the Performance of Endoscopy)

AU - Zorzi, Manuel

AU - Senore, Carlo

AU - Da Re, Filippo

AU - Barca, Alessandra

AU - Bonelli, Luigina Ada

AU - Cannizzaro, Renato

AU - Fasoli, Renato

AU - Furia, Lucia Di

AU - Giulio, Emilio Di

AU - Mantellini, Paola

AU - Naldoni, Carlo

AU - Sassatelli, Romano

AU - Rex, Douglas

AU - Hassan, Cesare

AU - Zappa, Marco

PY - 2015/9/1

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N2 - Objectives: To assess variation in the main colonoscopy quality indicators in organised colorectal cancer (CRC) screening programmes based on faecal immunochemical test (FIT). Design: Data from a case-series of colonoscopies of FIT-positive subjects were provided by 44 Italian CRC screening programmes. Data on screening history, endoscopic procedure and histology results, and additional information on the endoscopy centre and the endoscopists were collected. The adenoma detection rate (ADR) and caecal intubation rate (CIR) were assessed for the whole population and the individual endoscopists. To explore variation in the quality indicators, multilevel analyses were performed according to patient/centre/endoscopist characteristics. Results: We analysed 75 569 (mean age: 61.3 years; men: 57%) colonoscopies for positive FIT performed by 479 endoscopists in 79 centres. ADR ranged from 13.5% to 75% among endoscopists (mean: 44.8%). ADR was associated with gastroenterology specialty (OR: 0.87 for others, 95% CI 0.76 to 0.96) and, at the endoscopy centre level, with the routine use of sedation (OR: 0.80 if occasional (600 colonoscopies; 95% CI 1.11 to 2.04) and, at the endoscopy centre level, screeningdedicated sessions (OR: 2.18; 95% CI 1.24 to 3.83) and higher rates of sedation (OR: 0.47 if occasional; 95% CI 0.24 to 0.92). Conclusions: The quality of colonoscopy was affected by patient-related, endoscopist-related and centre-related characteristics. Policies addressing organisational issues should improve the quality of colonoscopy in our programme and similar programmes.

AB - Objectives: To assess variation in the main colonoscopy quality indicators in organised colorectal cancer (CRC) screening programmes based on faecal immunochemical test (FIT). Design: Data from a case-series of colonoscopies of FIT-positive subjects were provided by 44 Italian CRC screening programmes. Data on screening history, endoscopic procedure and histology results, and additional information on the endoscopy centre and the endoscopists were collected. The adenoma detection rate (ADR) and caecal intubation rate (CIR) were assessed for the whole population and the individual endoscopists. To explore variation in the quality indicators, multilevel analyses were performed according to patient/centre/endoscopist characteristics. Results: We analysed 75 569 (mean age: 61.3 years; men: 57%) colonoscopies for positive FIT performed by 479 endoscopists in 79 centres. ADR ranged from 13.5% to 75% among endoscopists (mean: 44.8%). ADR was associated with gastroenterology specialty (OR: 0.87 for others, 95% CI 0.76 to 0.96) and, at the endoscopy centre level, with the routine use of sedation (OR: 0.80 if occasional (600 colonoscopies; 95% CI 1.11 to 2.04) and, at the endoscopy centre level, screeningdedicated sessions (OR: 2.18; 95% CI 1.24 to 3.83) and higher rates of sedation (OR: 0.47 if occasional; 95% CI 0.24 to 0.92). Conclusions: The quality of colonoscopy was affected by patient-related, endoscopist-related and centre-related characteristics. Policies addressing organisational issues should improve the quality of colonoscopy in our programme and similar programmes.

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