Key performance measures for colonoscopy in the Polish Colonoscopy Screening Program.

Area of Science:

• Gastroenterology
• Public Health
• Endoscopy Quality Improvement

Background:

• The European Society of Gastrointestinal Endoscopy (ESGE) established key performance measures for colonoscopy quality.
• The Polish Colonoscopy Screening Program (PCSP) implemented these measures to assess adherence and monitoring feasibility.

Purpose of the Study:

• To evaluate the adherence of the PCSP to ESGE's recommended colonoscopy performance standards.
• To determine the feasibility of monitoring these quality indicators within the PCSP framework.

Main Methods:

• Analysis of 43,277 PCSP participant records from 25 centers (2014-2015).
• Calculation of ESGE performance measures using PCSP database and external registries for complications.
• Comparison of calculated values against proposed ESGE standards at program, center, and individual levels.

Main Results:

• The PCSP met four of five minimum standards and one of two target standards at the program level.
• Key performance indicators included: adequate bowel preparation (91.3%), cecal intubation (97.4%), adenoma detection rate (29.8%), and appropriate polypectomy technique (62.7%).
• Complication rates were low (7-day hospitalization 0.3%, 30-day mortality 0.02%), and post-polypectomy surveillance was appropriate in 95.4% of cases. Monitoring was feasible for most measures, except complications requiring external data.

Conclusions:

• The PCSP demonstrates substantial compliance with minimum ESGE colonoscopy quality standards at the program level.
• Specific centers may require targeted interventions to achieve full compliance with all quality benchmarks.
• The ESGE performance measures are generally suitable for monitoring colonoscopy quality within a national screening program.