Quality assurance and recommendations for quality assessment of screening colonoscopy in Belgium

As population-wide screening for colorectal cancer is adopted by many western countries for all individuals aged 50-75. The success of screening colonoscopy programs is highly dependent on the quality of the procedures. High-quality complete endoscopy with excellent patient preparation and adequate withdrawal time is necessary for effectively reducing colon cancer risk. In Belgium formal quality assurance programs and principles of credentialing do not exist. The current reimbursement system for colonoscopy does not reward a careful performed examination but rapidly performed examinations at unnecessarily short intervals. There is a clear need for evidence-based quality measures to ensure the quality of screening colonoscopy. In this guideline review we present an overview of the literature concerning criteria for best practice and important quality indica- tors for colonoscopy. A summary of the latest guidelines is given. Our goal of this update is to provide practical guidelines for endo- scopists performing screening colonoscopy. We hope to provide a broad consensus and an increasing adherence to these recommen- dations. (Acta gastroenterol. belg., 2009, 72, 17-25).