[Essential quality criteria in the indication and performance of colonoscopy]

Colonoscopy is the gold standard for the diagnosis and treatment of diseases of the colon and, especially, for screening and surveillance of colorectal cancer. Because of the rapid and progressive rise in the number of procedures performed in the last few years and the inherent risks of this increase, quality criteria for the indication and performance of this procedure are required. These criteria should be standardized for all endoscopists and endoscopy units; moreover, continual evaluation of the staff and units performing this procedure should be carried out. Medical societies and the health administration should audit endoscopists and endoscopy units (appendix 1) to guarantee correct application of this technique, which could allow the prevention, diagnosis and treatment of some of the most frequent severe diseases in our environment. Guaranteeing appropriate indications requires effective management methods in primary care and basic gastroenterology care. For the correct performance of colonoscopy, the following factors are required: appropriate endoscopist training and experience, resources for rapid scheduling, the application of systems that improve tolerance, correct preparation, the establishment of appropriate intervals between procedures, the conditions required to perform the technique correctly, and knowledge of the lesions, detection systems, and treatment of the complications associated with colonoscopy.