Heart of England NHS Foundation Trust, Heartlands Hospital, Birmingham, UK.
Colorectal Dis. 2016 Sep;18(9):903-9. doi: 10.1111/codi.13291.
Colonoscopy performed as part of the NHS Bowel Cancer Screening Programme (BCSP) is of high standard as measured using global rating scale (GRS) criteria. Screening practitioners also provide a non-screening colonoscopy service. The current study compares colonoscopy quality indicators between screening and non-screening groups performed by a single practitioner using the GRS.
Patient details were obtained for all consecutive colonoscopies between 2007 and 2014 performed by a single screening practitioner. Data were collected retrospectively from electronic patient records; BCSP Exeter database and non-screening colonoscopies were compared. Data included patient demographics (age, gender), sedation, and the GRS data including caecal intubation, adenoma and neoplasia detection rates.
In all, 1961 colonoscopy procedures (1067 screening and 894 non-screening) were identified; 57% were men. Mean (SD) age for all patients was 64 (± 10.4) years. Non-screening patients were younger [62 (± 14) vs 66 (± 4.8) years; P < 0.05] and were less likely to be men (51.5% vs 61.9%; P < 0.05) than their screening counterparts. Caecal intubation was more successful in screening patients [1027/1067 (96.3%)] than non-screening patients [805/894 (90%)]; P < 0.05. Adenoma detection rate was higher in the screening (46.8 ± 4.4) than non-screening (26.3 ± 11.8) group; P < 0.05. There were no differences in neoplasia detection. Polypectomy was more likely (55.5% vs 30.2%) and polyp retrieval more successful (97.5% vs 86.7%) in the screening group.
Screening and non-screening colonoscopy differ in the GRS domains of completion and pathology detection. These differences need to be acknowledged when comparing screeners and non-screeners using GRS within units.
使用全球评分量表（GRS）标准衡量，作为国民保健制度（NHS）结直肠癌筛查计划（BCSP）一部分的结肠镜检查具有高标准。筛查医生还提供非筛查结肠镜检查服务。本研究比较了同一位医生进行的筛查组和非筛查组的结肠镜检查质量指标，使用 GRS 进行评估。
收集了 2007 年至 2014 年间由一位筛查医生进行的所有连续结肠镜检查的患者详细信息。数据从电子患者记录、埃克塞特 BCSP 数据库中回顾性收集，比较了筛查和非筛查结肠镜检查。数据包括患者人口统计学信息（年龄、性别）、镇静情况以及 GRS 数据，包括盲肠插管、腺瘤和肿瘤检出率。
共确定了 1961 例结肠镜检查（1067 例筛查和 894 例非筛查）；57%为男性。所有患者的平均（标准差）年龄为 64（±10.4）岁。非筛查患者年龄较小[62（±14）岁比 66（±4.8）岁；P<0.05]，男性比例较低（51.5%比 61.9%；P<0.05）。筛查患者的盲肠插管成功率更高[1027/1067（96.3%）]，而非筛查患者为[805/894（90%）]；P<0.05。筛查组的腺瘤检出率较高[46.8±4.4]，而非筛查组为[26.3±11.8]；P<0.05。两组在肿瘤检出率方面无差异。在筛查组中，息肉切除术更有可能（55.5%比 30.2%），息肉回收更成功（97.5%比 86.7%）。
筛查和非筛查结肠镜检查在完成情况和病理检测的 GRS 领域存在差异。在单位内使用 GRS 比较筛查者和非筛查者时，需要注意这些差异。
