Journal of General Internal Medicine

, Volume 25, Issue 11, pp 1230–1234 | Cite as

The Quality of Colonoscopy Services—Responsibilities of Referring Clinicians

A Consensus Statement of the Quality Assurance Task Group, National Colorectal Cancer Roundtable
  • Robert H. FletcherEmail author
  • Marion R. Nadel
  • John I. Allen
  • Jason A. Dominitz
  • Douglas O. Faigel
  • David A. Johnson
  • Dorothy S. Lane
  • David Lieberman
  • John B. Pope
  • Michael B. Potter
  • Deborah P. Robin
  • Paul C. SchroyIII
  • Robert A. Smith


Primary care clinicians initiate and oversee colorectal screening for their patients, but colonoscopy, a central component of screening programs, is usually performed by consultants. The accuracy and safety of colonoscopy varies among endoscopists, even those with mainstream training and certification. Therefore, it is a primary care responsibility to choose the best available colonoscopy services. A working group of the National Colorectal Cancer Roundtable identified a set of indicators that primary care clinicians can use to assess the quality of colonoscopy services. Quality measures are of actual performance, not training, specialty, or experience alone. The main elements of quality are a complete report, technical competence, and a safe setting for the procedure. We provide explicit criteria that primary care physicians can use when choosing a colonoscopist. Information on quality indicators will be increasingly available with quality improvement efforts within the colonoscopy community and growth in the use of electronic medical records.


primary care clinicians colorectal screening endoscopist colonoscopist 



This work was supported by the Division of Cancer Prevention and Control at the Centers for Disease Control and Prevention, the American Cancer Society and the VA Puget Sound Health Care System, Department of Veterans Affairs. Dr. Dominitz was supported by an American Society for Gastrointestinal Endoscopy Career Development Award.

The views expressed in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the Department of Veterans Affairs.

Conflict of Interest

None of the authors has a financial tie to entities that would stand to gain financially from implementation of the recommendations in this statement.


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Copyright information

© Society of General Internal Medicine 2010

Authors and Affiliations

  • Robert H. Fletcher
    • 1
    • 13
    Email author
  • Marion R. Nadel
    • 2
  • John I. Allen
    • 3
  • Jason A. Dominitz
    • 4
  • Douglas O. Faigel
    • 5
  • David A. Johnson
    • 6
  • Dorothy S. Lane
    • 7
  • David Lieberman
    • 5
  • John B. Pope
    • 8
  • Michael B. Potter
    • 9
  • Deborah P. Robin
    • 10
  • Paul C. SchroyIII
    • 11
  • Robert A. Smith
    • 12
  1. 1.Harvard Medical School and Harvard Pilgrim Health CareBostonUSA
  2. 2.Division of Cancer Prevention and ControlCenters for Disease Control and PreventionAtlantaUSA
  3. 3.Minnesota GastroenterologySaint PaulUSA
  4. 4.VA Puget Sound Heath Care SystemSeattleUSA
  5. 5.Oregon Health and Sciences UniversityPortlandUSA
  6. 6.Eastern Virginia Medical SchoolNorfolkUSA
  7. 7.Stony Brook University School of MedicineStony BrookUSA
  8. 8.Louisiana State University of MedicineShreveporUSA
  9. 9.University of California San FranciscoSan FranciscoUSA
  10. 10.American Gastroenterological AssociationBethesdaUSA
  11. 11.Boston University School of MedicineBostonUSA
  12. 12.The American Cancer SocietyAtlantaUSA
  13. 13.Chapel HillUSA

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