• ENDOSCOPY

Patients requiring lower GI endoscopy should rightly expect a procedure which is safe, comfortable and effective. Effectiveness is achieved by complete intubation, careful mucosal inspection, recognition and accurate characterisation of any abnormality together with competent delivery of appropriate therapy. These statements seem self-evident today in an era of established quality assurance (QA) of both service and training provision, but it was not so long ago that the landscape looked very different.

As the evidence for population-based screening for colorectal cancer accumulated through the 1990s, it was recognised that the capacity available and quality of delivery of colonoscopy were too poor and variable for this evidence to be translated into an effective programme, summarised in a joint position statement in 2000.1 Just 19 years ago, 2004 was a notable year. Publication of a prospective audit of UK colonoscopy by Bowles et al provided challenging evidence of incomplete examinations with caecal intubation rates of <80% and evidence of significant levels of discomfort and morbidity associated with the procedure.2 The Joint Advisory Group (JAG) for GI …