Study Recommends Standardization of Colonoscopy Training

A cautionary study out of the University of Manitoba indicates that colonoscopy could be missing as many as 8% of all cancers.

A research team, led by Dr. Harminder Singh, identified 4,883 “individuals 50-80 years of age diagnosed with colorectal between 1992 and 2008 from the provincewide Manitoba Cancer Registry” and found that 388 cancers had been missed, “with a range of 4.5% of rectum/rectosigmoid cancers in men to 14.4% of transverse colon/splenic flexure cancers in women.”

The authors were unclear as to whether the differences between missed cancers in men and women related to “differences in procedure difficulty, bowel preparation issues, or tumor biology between men and women.”

Dr. David Lieberman of the Oregon Health and Science University tells Reuters that though the missed cancers could have been “seen but not completely removed” or grown quickly after going undetected during examination, “patients were referred for colonoscopy, most commonly due to symptoms,” which “is very different from a population undergoing screening.”

Regardless of the causes, Singh believes that his team’s findings highlight a need for standardization of colonoscopy that includes credentialing and re-credentialing.

“There is an urgent need to focus on and improve the outcomes of colonoscopy,” he told Reuters in an e-mail.

In your opinion, does the gastroenterology community require a better focus on colonoscopy training or do you feel that this study represents something unavoidable or isolated? Would you feel more comfortable in your abilities if you were required to re-certify every few years?