Enhancing Colonoscopy Quality: Evaluating Adherence to Performance Measures in Ukraine

Colonoscopy is a proven screening method for reducing mortality from colorectal cancer (CRC), the most frequently diagnosed cancer in Ukraine. To enhance colonoscopy quality, international societies have defined key performance measures (PMs). We aimed to evaluate adherence to these PMs among Ukrainian endoscopists and explore factors affecting screening colonoscopy quality.

We conducted a cross-sectional study using a web-based survey among members of Ukraine's endoscopy society EndoAcademy (Kyiv, Ukraine) (October-November 2023). The questionnaire assessed colonoscopy practices and adherence to globally recognized PMs, categorized as six calculated (requiring ongoing numerical data tracking) and six noncalculated (performed/not performed practices).

Of 540 invited endoscopists, 122 (22.6%) responded. The median number of adhered to quality PMs was 6 (IQR, 5-8), with noncalculated being reported more frequently: medians 4 (IQR, 4-5) versus 2 (IQR, 1-3), P < .01. Among noncalculated PMs, most common were postpolypectomy surveillance recommendations (98.4%, n = 120) and retrieval of removed polyps (96.7%, n = 118). For calculated PMs, cecal intubation (61.5%, n = 75) and adenoma detection (59.8%, n = 73) rates were most frequently reported. In multivariable analysis, adherence to each additional quality PM increased the odds of optimal polyp treatment (odds ratio [OR], 1.32 [95% CI, 1.03 to 1.70]), with photo/video recording (OR, 7.57 [95% CI, 1.66 to 34.49]) and adequate procedure time allocation (OR, 3.86 [95% CI, 1.18 to 12.61]) showing the strongest associations.

To our knowledge, this first national study of colonoscopy PMs in Ukraine highlights key documentation gaps and variation in polyp management. As the country implements a population-based CRC screening program, structured quality assurance, audit-and-feedback systems, and education grounded in international PMs will be critical to improving outcomes.