Quality Criteria for Colonoscopy in Sub-Saharan Africa: Results from Two Gastrointestinal Endoscopy Centers in Dakar

Abstract

Introduction: Colonoscopy is the reference standard for colonic evaluation and the prevention of colorectal cancer. Its diagnostic performance and safety depend on adherence to validated quality indicators. Our objective was to assess colonoscopy quality criteria in two reference endoscopy centers in Dakar. Patients and Methods : This was a multicenter, retrospective, descriptive, and analytical study conducted between April 1, 2021, and July 31, 2022. All patients who underwent colonoscopy with an interpretable report were included. We collected sociodemographic data, indications for the examination, colon preparation methods and quality, operator level, examination tolerance, colonoscopy findings, histopathological data on lesions, and the endoscopic treatment performed. Data entry was performed using Excel software, and statistical analysis was conducted using STATA software. Results: All patients underwent a pre-colonoscopy consultation, and 75.9% of indications were deemed appropriate according to the 2012 ASGE criteria. All patients received bowel preparation with polyethylene glycol 4 L in split dosing. Adequate preparation, defined as a Boston score ≥ 6, was achieved in 94.4% of colonoscopies. The overall cecal intubation rate was 86.5% and reached 92.1% after excluding impassable tumoral strictures. The polyp detection rate was 18.3% in the overall population and 24.2% among patients aged 50 years and older. Polypectomy was performed in 44.4% of detected polyps, with a retrieval rate of 95%. Conclusion: Several major indicators of colonoscopy quality met international standards. However, improved documentation of quality indicators, histological data, and examination conditions remains necessary to optimize the overall quality of colonoscopy.