What is the best measure of quality in a gastroenterologist?

How do you choose a gastroenterologist for your screening colonoscopy?  Everyone wants “a good doctor” but how do you evaluate your gastroenterologist?

If a gastroenterologist is diligent, thorough and spends adequate time during a colonoscopy, polyp detection improves.  Polyp detection is key since the removal of adenomatous (precancerous) polyps has been shown in tightly controlled studies to prevent colon cancer.  It is estimated that in an unscreened population of healthy adults ranging in age from 50 to 60, 30% will have 1 or more polyps.  If a gastroenterologist has a perfect adenoma (polyp) detection rate, this detection rate will be close to 30% in a screening population.  That is, 30% of patients will be found to have 1 or more polyps.

It is believed but not proven, that a high adenoma detection rate in clinical practice will reduce the incidence of colon cancer in the general population.  In a prospective large, long term study  published this month in Gastroenterology, endoscopists who had an adenoma detection rate of greater than 25% were significantly more effective in preventing colon cancer in their patients.  So, when you consult a gastroenterologist for a screening colonoscopy ask this question “What is your adenoma detection rate?”

Exceptional gastroenterologist in the US will have an adenoma detection rate of 28%; the adenoma detection rate at Gastroenterology Group of Naples is 27.5%.   For a more comprehensive discussion about the quality in screening colonoscopy please review this video.

Raymond W. Phillips MD