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Endoscopy 2012; 44(S 03): SE88-SE105
DOI: 10.1055/s-0032-1309795
Guidelines
© Georg Thieme Verlag KG Stuttgart · New York

European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition – Quality assurance in endoscopy in colorectal cancer screening and diagnosis

R. Valori
1   Gloucestershire Royal Hospital, Gloucester, United Kingdom
,
J-F. Rey
2   Institut Arnault Tzanck, Saint Laurent du Var, France
,
W. S. Atkin
3   Imperial College London, London, United Kingdom
,
M. Bretthauer
4   Cancer Registry of Norway and the Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
,
C. Senore
5   CPO Piemonte and S. Giovanni University Hospital, Turin. Italy
,
G. Hoff
6   Cancer Registry of Norway, Oslo, Norway
,
E. J. Kuipers
7   Erasmus MC University Medical Center, Rotterdam, the Netherlands
,
L. Altenhofen
8   Central Research Institute of Ambulatory Health Care, Berlin, Germany
,
R. Lambert
9   Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
,
G. Minoli
10   Gastroenterology Unit, Valduce Hospital, Como, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
25 September 2012 (online)

Also available at
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Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on quality assurance in endoscopy includes 50 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of endoscopy and other elements in the screening process, including multidisciplinary diagnosis and management of the disease.

Keywords

mass screening - colorectal neoplasms - endoscopy - colonoscopy - flexible sigmoidoscopy - evidence-based guidelines - multidisciplinary population-based programmes
 

  • References

  • 1 Adler A, Aschenbeck J, Yenerim T et al. Narrow-band versus white-light high definition television endoscopic imaging for screening colonoscopy: a prospective randomized trial. Gastroenterology 2009; 136: 410-416
    CrossrefPubMedSearch in Google Scholar
  • 2 Aoun E, bdul-Baki H, Azar C et al. A randomized single-blind trial of split-dose PEG-electrolyte solution without dietary restriction compared with whole dose PEG-electrolyte solution with dietary restriction for colonoscopy preparation. Gastrointest Endosc 2005; 62: 213-218
    CrossrefPubMedSearch in Google Scholar
  • 3 Atkin W, Valori R, Kuipers EJ et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Colonoscopic surveillance following adenoma removal. Endoscopy 2012; 44: SE151-SE163
    Thieme ConnectPubMedSearch in Google Scholar
  • 4 Atkin WS, Hart A, Edwards R et al. Single blind, randomised trial of efficacy and acceptability of oral picolax versus self administered phosphate enema in bowel preparation for flexible sigmoidoscopy screening. BMJ 2000; 320: 1504-1508
    CrossrefPubMedSearch in Google Scholar
  • 5 Austoker J, Giordano L, Hewitson P et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Communication. Endoscopy 2012; 44: SE164-SE185
    Thieme ConnectPubMedSearch in Google Scholar
  • 6 Barclay RL, Vicari JJ, Doughty AS et al. Colonoscopic withdrawal times and adenoma detection during screening colonoscopy. N Engl J Med 2006; 355: 2533-2541
    CrossrefPubMedSearch in Google Scholar
  • 7 Barton R. Accrediting Competence in Colonoscopy: Validity and Reliability of the UK Joint Advisory Group/NHS Bowel Cancer Screening Programme Accreditation Assessment. Gastrointestinal Endoscopy 2008; 67 AB77
    PubMedSearch in Google Scholar
  • 8 Beilenhoff U, Neumann CS, Rey JF et al. ESGE-ESGENA Guideline: cleaning and disinfection in gastrointestinal endoscopy. Endoscopy 2008; 40: 939-957
    Thieme ConnectPubMedSearch in Google Scholar
  • 9 Beilenhoff U, Neumann CS, Rey JF et al. ESGE-ESGENA guideline for quality assurance in reprocessing: microbiological surveillance testing in endoscopy. Endoscopy 2007; 39: 175-181
    Thieme ConnectPubMedSearch in Google Scholar
  • 10 Belsey J, Epstein O, Heresbach D. Systematic review: oral bowel preparation for colonoscopy. Aliment Pharmacol Ther 2007; 25: 373-384
    CrossrefPubMedSearch in Google Scholar
  • 11 Bernstein C, Thorn M, Monsees K et al. A prospective study of factors that determine cecal intubation time at colonoscopy. Gastrointest Endosc 2005; 61: 72-75
    CrossrefPubMedSearch in Google Scholar
  • 12 Bigard MA, Gaucher P, Lassalle C. Fatal colonic explosion during colonoscopic polypectomy. Gastroenterology 1979; 77: 1307-1310
    PubMedSearch in Google Scholar
  • 13 Bini EJ, Firoozi B, Choung RJ et al. Systematic evaluation of complications related to endoscopy in a training setting: A prospective 30-day outcomes study. Gastrointest Endosc 2003; 57: 8-16
    CrossrefPubMedSearch in Google Scholar
  • 14 Bini EJ, Unger JS, Rieber JM et al. Prospective, randomized, single-blind comparison of two preparations for screening flexible sigmoidoscopy. Gastrointest Endosc 2000; 52: 218-222
    CrossrefPubMedSearch in Google Scholar
  • 15 Bressler B, Paszat LF, Chen Z et al. Rates of new or missed colorectal cancers after colonoscopy and their risk factors: a population-based analysis. Gastroenterology 2007; 132: 96-102
    CrossrefPubMedSearch in Google Scholar
  • 16 Bretthauer M, Hoff G, Thiis-Evensen E et al. Carbon dioxide insufflation reduces discomfort due to flexible sigmoidoscopy in colorectal cancer screening. Scand J Gastroenterol 2002; 37: 1103-1107
    CrossrefPubMedSearch in Google Scholar
  • 17 Bretthauer M, Hoff GS, Thiis-Evensen E et al. Air and carbon dioxide volumes insufflated during colonoscopy. Gastrointest Endosc 2003; 58: 203-206
    CrossrefPubMedSearch in Google Scholar
  • 18 Bretthauer M, Lynge AB, Thiis-Evensen E et al. Carbon dioxide insufflation in colonoscopy: safe and effective in sedated patients. Endoscopy 2005; 37: 706-709
    Thieme ConnectPubMedSearch in Google Scholar
  • 19 Bretthauer M, Thiis-Evensen E, Huppertz-Hauss G et al. NORCCAP (Norwegian colorectal cancer prevention): a randomised trial to assess the safety and efficacy of carbon dioxide versus air insufflation in colonoscopy. Gut 2002; 50: 604-607
    CrossrefPubMedSearch in Google Scholar
  • 20 Brown SR, Baraza W, Hurlstone P. Chromoscopy versus conventional endoscopy for the detection of polyps in the colon and rectum. Cochrane Database Syst Rev 2007; CD006439
    PubMedSearch in Google Scholar
  • 21 Burke CA, Choure AG, Sanaka MR et al. A Comparison of High-Definition Versus Conventional Colonoscopes for Polyp Detection. Dig Dis Sci 2009;
    PubMedSearch in Google Scholar
  • 22 Church J, Delaney C. Randomized, controlled trial of carbon dioxide insufflation during colonoscopy. Dis Colon Rectum 2003; 46: 322-326
    CrossrefPubMedSearch in Google Scholar
  • 23 Cohen LB. Split dosing of bowel preparations for colonoscopy: an analysis of its efficacy, safety, and tolerability. Gastrointest Endosc 2010; 72: 406-412
    CrossrefPubMedSearch in Google Scholar
  • 24 Condon A, Graff L, Elliot L et al. Acceptance of colonoscopy requires more than test tolerance. Can J Gastroenterol 2008; 22: 41-47
    PubMedSearch in Google Scholar
  • 25 Council of the European Union. Council Recommendation of 2 December 2003 on cancer screening (2003/878/EC). Off J Eur Union; 2003: 34-38
    PubMedSearch in Google Scholar
  • 26 Dafnis G, Ekbom A, Pahlman L et al. Complications of diagnostic and therapeutic colonoscopy within a defined population in Sweden. Gastrointest Endosc 2001; 54: 302-309
    CrossrefPubMedSearch in Google Scholar
  • 27 Denberg TD, Melhado TV, Coombes JM et al. Predictors of nonadherence to screening colonoscopy. J Gen Intern Med 2005; 20: 989-995
    CrossrefPubMedSearch in Google Scholar
  • 28 East JE, Stavrindis M, Thomas-Gibson S et al. A comparative study of standard vs. high definition colonoscopy for adenoma and hyperplastic polyp detection with optimized withdrawal technique.. Aliment Pharmacol Ther 2008; 28: 768-776
    CrossrefPubMedSearch in Google Scholar
  • 29 Eckardt VF, Kanzler G, Schmitt T et al. Complications and adverse effects of colonoscopy with selective sedation. Gastrointest Endosc 1999; 49: 560-565
    CrossrefPubMedSearch in Google Scholar
  • 30 Eloubeidi MA, Wallace MB, Desmond R et al. Female gender and other factors predictive of a limited screening flexible sigmoidoscopy examination for colorectal cancer. Am J Gastroenterol 2003; 98: 1634-1639
    CrossrefPubMedSearch in Google Scholar
  • 31 Emura F, Saito Y, Taniguchi M et al. Further validation of magnifying chromocolonoscopy for differentiating colorectal neoplastic polyps in a health screening center. J Gastroenterol Hepatol 2007; 22: 1722-1727
    CrossrefPubMedSearch in Google Scholar
  • 32 Enns R. Quality indicators in colonoscopy. Can J Gastroenterol 2007; 21: 277-279
    PubMedSearch in Google Scholar
  • 33 Ferlay J, Shin HR, Bray F et al. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10. [Internet] Lyon, France: International Agency for Research on Cancer; 2010 Available from: http://globocan.iarc.fr Accessed on 05/04/2012
    PubMedSearch in Google Scholar
  • 34 Halloran S, Launoy G, Zappa M. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Faecal Occult Blood Testing. Endoscopy 2012; 44: SE65-SE87
    Thieme ConnectPubMedSearch in Google Scholar
  • 35 Harris JK, Froehlich F, Wietlisbach V et al. Factors associated with the technical performance of colonoscopy: An EPAGE Study. Dig Liver Dis 2007; 39: 678-689
    CrossrefPubMedSearch in Google Scholar
  • 36 Harris JK, Vader JP, Wietlisbach V et al. Variations in colonoscopy practice in Europe: a multicentre descriptive study (EPAGE). Scand J Gastroenterol 2007; 42: 126-134
    CrossrefPubMedSearch in Google Scholar
  • 37 Hoff G, Grotmol T, Skovlund E et al. Risk of colorectal cancer seven years after flexible sigmoidoscopy screening: randomised controlled trial. BMJ 2009; 338: b1846
    CrossrefPubMedSearch in Google Scholar
  • 38 Hui AJ, Wong RM, Ching JY et al. Risk of colonoscopic polypectomy bleeding with anticoagulants and antiplatelet agents: analysis of 1657 cases. Gastrointest Endosc 2004; 59: 44-48
    CrossrefPubMedSearch in Google Scholar
  • 39 Inoue T, Murano M, Murano N et al. Comparative study of conventional colonoscopy and pan-colonic narrow-band imaging system in the detection of neoplastic colonic polyps: a randomized, controlled trial. J Gastroenterol 2008; 43: 45-50
    CrossrefPubMedSearch in Google Scholar
  • 40 Janssens F, Deviere J, Eisendrath P et al. Carbon dioxide for gut distension during digestive endoscopy: technique and practice survey. World J Gastroenterol 2009; 15: 1475-1479
    CrossrefPubMedSearch in Google Scholar
  • 41 Johanson JF. Practicality of high-resolution chromoendoscopy during routine screening colonoscopy. Gastrointest Endosc 2006; 63: 829-830
    CrossrefPubMedSearch in Google Scholar
  • 42 Kaltenbach T, Friedland S, Soetikno R. A randomised tandem colonoscopy trial of narrow band imaging versus white light examination to compare neoplasia miss rates. Gut 2008; 57: 1406-1412
    CrossrefPubMedSearch in Google Scholar
  • 43 Kaltenbach T, Sano Y, Friedland S et al. American Gastroenterological Association (AGA) Institute technology assessment on image-enhanced endoscopy. Gastroenterology 2008; 134: 327-340
    CrossrefPubMedSearch in Google Scholar
  • 44 Kaminski MF, Regula J, Kraszewska E et al. Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med 2010; 362: 1795-1803
    CrossrefPubMedSearch in Google Scholar
  • 45 Katagiri A, Fu KI, Sano Y et al. Narrow band imaging with magnifying colonoscopy as diagnostic tool for predicting histology of early colorectal neoplasia. Aliment Pharmacol Ther 2008; 27: 1269-1274
    CrossrefPubMedSearch in Google Scholar
  • 46 Kudo S, Lambert R, Allen JI et al. Nonpolypoid neoplastic lesions of the colorectal mucosa. Gastrointest Endosc 2008; 68: 3-47
    PubMedSearch in Google Scholar
  • 47 Ladas SD, Karamanolis G, Ben-Soussan E. Colonic gas explosion during therapeutic colonoscopy with electrocautery. World J Gastroenterol 2007; 13: 5295-5298
    CrossrefPubMedSearch in Google Scholar
  • 48 Landsorp-Vogelaar I, von Karsa L. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Introduction. Endoscopy 2012; 44: SE15-SE30
    Thieme ConnectPubMedSearch in Google Scholar
  • 49 Lee KK, Anderson MA, Baron TH et al. Modifications in endoscopic practice for pediatric patients. Gastrointest Endosc 2008; 67: 1-9
    CrossrefPubMedSearch in Google Scholar
  • 50 Levin TR, Farraye FA, Schoen RE et al. Quality in the technical performance of screening flexible sigmoidoscopy: recommendations of an international multi-society task group. Gut 2005; 54: 807-813
    CrossrefPubMedSearch in Google Scholar
  • 51 Lieberman DA, Weiss DG, Bond JH et al. Use of colonoscopy to screen asymptomatic adults for colorectal cancer. Veterans Affairs Cooperative Study Group 380.. N Engl J Med 2000; 343: 162-168
    CrossrefPubMedSearch in Google Scholar
  • 52 Malila N, Senore C, Armaroli P. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Organisation. Endoscopy 2012; 44: SE31-SE48
    Thieme ConnectPubMedSearch in Google Scholar
  • 53 Matsuda T, Saito Y, Fu KI et al. Does autofluorescence imaging videoendoscopy system improve the colonoscopic polyp detection rate? -- a pilot study.. Am.J.Gastroenterol 2008; 103: 1926-1932
    PubMedSearch in Google Scholar
  • 54 Mayinger B, Neumann F, Kastner C et al. Early detection of premalignant conditions in the colon by fluorescence endoscopy using local sensitization with hexaminolevulinate. Endoscopy 2008; 40: 106-109
    Thieme ConnectPubMedSearch in Google Scholar
  • 55 McCallum AL, Jenkins JT, Gillen D et al. Evaluation of autofluorescence colonoscopy for the detection and diagnosis of colonic polyps. Gastrointest Endosc 2008; 68: 283-290
    CrossrefPubMedSearch in Google Scholar
  • 56 McLachlan S, Clements A, Austoker J. Patients' experiences and reported barriers to screening colonoscopy: A systematic review. J Clin Oncol 2009; 27: 1537
    CrossrefPubMedSearch in Google Scholar
  • 57 McQuaid KR, Laine L. A systematic review and meta-analysis of randomized, controlled trials of moderate sedation for routine endoscopic procedures. Gastrointest Endosc 2008; 67: 910-923
    CrossrefPubMedSearch in Google Scholar
  • 58 Millan MS, Gross P, Manilich E et al. Adenoma detection rate: the real indicator of quality in colonoscopy. Dis Colon Rectum 2008; 51: 1217-1220
    CrossrefPubMedSearch in Google Scholar
  • 59 Minozzi S, Armaroli P, Banzi R et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis – First edition. Appendix 1: Systematic evidence review. 2010. http://bookshop.europa.eu/en/european-guidelines-for-quality-assurance-in-colorectal-cancer-screening-and-diagnosis-pbND3210390/ Accessed 11/2/2012
    Search in Google Scholar
  • 60 Minozzi S, Armaroli P, Segnan N. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Principles of evidence assessment and methods for reaching recommendations. Endoscopy 2012; 44: SE9-SE14
    Thieme ConnectPubMedSearch in Google Scholar
  • 61 Moss S, Ancelle-Park R, Brenner H. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Evaluation and interpretation of screening outcomes. Endoscopy 2012; 44: SE49-SE64
    Thieme ConnectPubMedSearch in Google Scholar
  • 62 Othman MO, Bradley AG, Choudhary A et al. Variable stiffness colonoscope versus regular adult colonoscope: meta-analysis of randomized controlled trials. Endoscopy 2009; 41: 17-24
    Thieme ConnectPubMedSearch in Google Scholar
  • 63 Parra-Blanco A, Nicolas-Perez D, Gimeno-Garcia A et al. The timing of bowel preparation before colonoscopy determines the quality of cleansing, and is a significant factor contributing to the detection of flat lesions: a randomized study. World J Gastroenterol 2006; 12: 6161-6166
    CrossrefPubMedSearch in Google Scholar
  • 64 Pellise M, Fernandez-Esparrach G, Cardenas A et al. Impact of wide-angle, high-definition endoscopy in the diagnosis of colorectal neoplasia: a randomized controlled trial. Gastroenterology 2008; 135: 1062-1068
    CrossrefPubMedSearch in Google Scholar
  • 65 Phaosawasdi K, Cooley W, Wheeler J et al. Carbon dioxide-insufflated colonoscopy: an ignored superior technique. Gastrointest Endosc 1986; 32: 330-333
    CrossrefPubMedSearch in Google Scholar
  • 66 Pohl J, Nguyen-Tat M, Pech O et al. Computed virtual chromoendoscopy for classification of small colorectal lesions: a prospective comparative study. Am J Gastroenterol 2008; 103: 562-569
    CrossrefPubMedSearch in Google Scholar
  • 67 Quirke P, Risio M, Lambert R et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Quality assurance in pathology in colorectal cancer screening and diagnosis. Endoscopy 2012; 44: SE116-SE130
    Thieme ConnectPubMedSearch in Google Scholar
  • 68 Rabeneck L, Paszat LF, Hilsden RJ et al. Bleeding and perforation after outpatient colonoscopy and their risk factors in usual clinical practice. Gastroenterology 2008; 135: 1899-1906
    CrossrefPubMedSearch in Google Scholar
  • 69 Radaelli F, Meucci G, Sgroi G et al. Technical performance of colonoscopy: the key role of sedation/analgesia and other quality indicators. Am J Gastroenterol 2008; 103: 1122-1130
    CrossrefPubMedSearch in Google Scholar
  • 70 Ramadori G, Lindhorst A, Armbrust T. Colorectal tumors with complete obstruction--endoscopic recovery of passage replacing emergency surgery? A report of two cases.. BMC Gastroenterol 2007; 7: 14
    CrossrefPubMedSearch in Google Scholar
  • 71 Rathgaber SW, Wick TM. Colonoscopy completion and complication rates in a community gastroenterology practice. Gastrointest Endosc 2006; 64: 556-562
    CrossrefPubMedSearch in Google Scholar
  • 72 Rex DK. Colonoscopic withdrawal technique is associated with adenoma miss rates. Gastrointest Endosc 2000; 51: 33-36
    CrossrefPubMedSearch in Google Scholar
  • 73 Rex DK. Colonoscopy. Gastrointest Endosc Clin N Am 2000; 10: 135-160 viii
    PubMedSearch in Google Scholar
  • 74 Rex DK. Maximizing detection of adenomas and cancers during colonoscopy. Am J Gastroenterol 2006; 101: 2866-2877
    CrossrefPubMedSearch in Google Scholar
  • 75 Rex DK, Bond JH, Winawer S et al. Quality in the technical performance of colonoscopy and the continuous quality improvement process for colonoscopy: recommendations of the U.S. Multi-Society Task Force on Colorectal Cancer.. Am J Gastroenterol 2002; 97: 1296-1308
    CrossrefPubMedSearch in Google Scholar
  • 76 Rex DK, Cutler CS, Lemmel GT et al. Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. Gastroenterology 1997; 112: 24-28
    CrossrefPubMedSearch in Google Scholar
  • 77 Rex DK, Imperiale TF, Portish V. Patients willing to try colonoscopy without sedation: associated clinical factors and results of a randomized controlled trial. Gastrointest Endosc 1999; 49: 554-559
    CrossrefPubMedSearch in Google Scholar
  • 78 Rodney WM, Randolph JF, Peterson DW. Cancellation rates and gas scores for air contrast barium enema immediately after 65-CM flexible sigmoidoscopy. A randomized clinical trial. J Clin Gastroenterol 1988; 10: 311-314
    CrossrefPubMedSearch in Google Scholar
  • 79 Rostom A, Jolicoeur E, Dube C et al. A randomized prospective trial comparing different regimens of oral sodium phosphate and polyethylene glycol-based lavage solution in the preparation of patients for colonoscopy. Gastrointest Endosc 2006; 64: 544-552
    CrossrefPubMedSearch in Google Scholar
  • 80 Rother T, Knopfle E, Bohndorf K. Virtual colonoscopy--and then? Relevance of small colorectal polyps.. Rofo 2007; 179: 130-136
    Thieme ConnectPubMedSearch in Google Scholar
  • 81 Segnan N, Patnick J, von Karsa L (eds.) European guidelines for quality assurance in colorectal cancer screening and diagnosis – First edition. Luxembourg: European Commission, Publications Office of the European Union; 2010
    Search in Google Scholar
  • 82 Segnan N, Senore C, Andreoni B et al. Randomized trial of different screening strategies for colorectal cancer: patient response and detection rates. J Natl Cancer Inst 2005; 97: 347-357
    CrossrefPubMedSearch in Google Scholar
  • 83 Segnan N, Senore C, Andreoni B et al. Comparing attendance and detection rate of colonoscopy with sigmoidoscopy and FIT for colorectal cancer screening. Gastroenterology 2007; 132: 2304-2312
    CrossrefPubMedSearch in Google Scholar
  • 84 Senore C, Segnan N, Rossini FP et al. Screening for colorectal cancer by once only sigmoidoscopy: a feasibility study in Turin, Italy. J Med Screen 1996; 3: 72-78
    PubMedSearch in Google Scholar
  • 85 Shah HA, Paszat LF, Saskin R et al. Factors associated with incomplete colonoscopy: a population-based study. Gastroenterology 2007; 132: 2297-2303
    CrossrefPubMedSearch in Google Scholar
  • 86 Shah SG, Brooker JC, Williams CB et al. Effect of magnetic endoscope imaging on colonoscopy performance: a randomised controlled trial. Lancet 2000; 356: 1718-1722
    CrossrefPubMedSearch in Google Scholar
  • 87 Shah SG, Brooker JC, Williams CB et al. The variable stiffness colonoscope: assessment of efficacy by magnetic endoscope imaging. Gastrointest Endosc 2002; 56: 195-201
    CrossrefPubMedSearch in Google Scholar
  • 88 Singh H, Penfold RB, DeCoster C et al. Colonoscopy and its complications across a Canadian regional health authority. Gastrointest Endosc 2009; 69: 665-671
    CrossrefPubMedSearch in Google Scholar
  • 89 Singh H, Poluha W, Cheung M et al. Propofol for sedation during colonoscopy. Cochrane Database Syst Rev 2008; CD006268
    PubMedSearch in Google Scholar
  • 90 Steele RJC, Pox C, Kuipers EJ et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Managment of lesions detected in colorectal cancer screening. Endoscopy 2012; 44: SE140-SE150
    Thieme ConnectPubMedSearch in Google Scholar
  • 91 Steele RJC, Rey J-F, Lambert R. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Professional requirements and training. Endoscopy 2012; 44: SE106-SE115
    Thieme ConnectPubMedSearch in Google Scholar
  • 92 Su MY, Hsu CM, Ho YP et al. Comparative study of conventional colonoscopy, chromoendoscopy, and narrow-band imaging systems in differential diagnosis of neoplastic and nonneoplastic colonic polyps. Am J Gastroenterol 2006; 101: 2711-2716
    CrossrefPubMedSearch in Google Scholar
  • 93 Sumanac K, Zealley I, Fox BM et al. Minimizing postcolonoscopy abdominal pain by using CO(2) insufflation: a prospective, randomized, double blind, controlled trial evaluating a new commercially available CO(2) delivery system. Gastrointest Endosc 2002; 56: 190-194
    CrossrefPubMedSearch in Google Scholar
  • 94 Thuraisingam AI, Brown JL, Anderson JT. What are the sensitivity and specificity of endoscopic photographs in determining completion of colonoscopy? Results from an online questionnaire.. Eur J Gastroenterol Hepatol 2008; 20: 567-571
    CrossrefPubMedSearch in Google Scholar
  • 95 Tischendorf JJ, Wasmuth HE, Koch A et al. Value of magnifying chromoendoscopy and narrow band imaging (NBI) in classifying colorectal polyps: a prospective controlled study. Endoscopy 2007; 39: 1092-1096
    Thieme ConnectPubMedSearch in Google Scholar
  • 96 Tsai MS, Su YH, Liang JT et al. Patient factors predicting the completion of sedation-free colonoscopy. Hepatogastroenterology 2008; 55: 1606-1608
    PubMedSearch in Google Scholar
  • 97 UK Trial. Single flexible sigmoidoscopy screening to prevent colorectal cancer: baseline findings of a UK multicentre randomised trial. Lancet 2002; 359: 1291-1300
    CrossrefPubMedSearch in Google Scholar
  • 98 Viiala CH, Olynyk JK. Outcomes for women in a flexible sigmoidoscopy-based colorectal cancer screening programme. Intern Med J 2008; 38: 90-94
    CrossrefPubMedSearch in Google Scholar
  • 99 von Karsa L, Anttila A, Ronco G et al. Cancer Screening in the European Union. Report on the implementation of the Council Recommendation on Cancer Screening - First Report. Luxembourg: European Commission; 2008 http://ec.europa.eu/health/archive/ph_determinants/genetics/documents/cancer_screening.pdf Accessed 11/2/2012
    PubMedSearch in Google Scholar
  • 100 von Karsa L, Lignini TA, Patnick J et al. The dimensions of the CRC problem. Best Pract Res Clin Gastroenterol 2010; 24: 381-396
    CrossrefPubMedSearch in Google Scholar
  • 101 Weissfeld JL, Schoen RE, Pinsky PF et al. Flexible sigmoidoscopy in the PLCO cancer screening trial: results from the baseline screening examination of a randomized trial. J Natl Cancer Inst 2005; 97: 989-997
    CrossrefPubMedSearch in Google Scholar
  • 102 WHO. WHO Pharmaceuticals Newsletter No.1. 2009
    PubMedSearch in Google Scholar
  • 103 Wilson JM, Jungner YG. Principles and practice of mass screening for disease. World Health Organization; 1968 http://whqlibdoc.who.int/php/WHO_PHP_34.pdf Accessed 11/2/2012
    PubMedSearch in Google Scholar
  • 104 Winawer SJ, Zauber AG, O'Brien MJ. The National Polyp Study Workgroup et al. Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. N Engl J Med 1993; 328: 901-906
    CrossrefPubMedSearch in Google Scholar
  • 105 Wong JC, Yau KK, Cheung HY et al. Towards painless colonoscopy: a randomized controlled trial on carbon dioxide-insufflating colonoscopy. ANZ J Surg 2008; 78: 871-874
    CrossrefPubMedSearch in Google Scholar