Endoscopists under examination

: In 2013 a nationwide screening for colorectal cancer in the Netherlands will start. As a consequence, the number of colonoscopies per year will rise and this will increase the demands for transparency concerning the individual skills of endoscopists and the endoscopy centres themselves. Quality indicators such as the percentage of colonoscopies in which the caecum was intubated, the adenoma detection rate (ADR), endoscope withdrawal time and the level of colon preparation should be monitored and controlled. A recent study in the Netherlands showed that the percentage of caecal intubation was close to or above the proposed standard of screening. The ADR was within quality limits, but the withdrawal time was not estimated. The colon preparation level surprisingly had no influence on ADR. When the national screening program starts, all participating endoscopists and centres must be sufficiently equipped to monitor their quality. This implies that audits should start in 2012.