Colonoscopy services in the United Kingdom

Background and Study Aims: Provision of a reasonable colonoscopy service re quires approximately 160 procedures per 100 000 population per year, The ai m of the present study was to document current levels of colonoscopy servic e, the use of guidelines in surveillance practice and the capacity for expa nsion in endoscopy units throughout the United Kingdom. Material and Methods: A postal questionnaire was sent to 294 endoscopy unit s, Results: Replies were received from 164 units (60%), Of the units, 49% have reached the calculated target figure. In units not meeting the target, 22% have only one colonoscopist, and 31% have one colonoscopy session a week. Overall, 50% of units are working at full capacity. Out of all units, 70% a re unable to expand their service further, because of lack of nursing suppo rt in 81%, non-availability of endoscopist in 72% and lack of physical spac e in 51%, Guidelines for surveillance colonoscopy were a problem: 51% of un its reported that guidelines were available for surveillance of ulcerative colitis, 28% for Crohn's disease, 59% for polyp follow-up, and 44% for foll ow-up of resected colorectal cancer. The majority of units (>70%) had no pr otocols for their surveillance practice. Nonetheless, 92% of units performe d surveillance colonoscopy for ulcerative colitis, 34% for Crohn's disease, and 76% for resected colorectal cancer, Conclusions: The colonoscopy service has expanded, but there are constraint s on further growth. There is a pressing need for national guidelines on su rveillance colonoscopy.