What I Need to Ask

Once you’ve been referred by your GP for a colonoscopy, find out who will be performing the procedure.

During the procedure, the colonoscopist spends most of the time looking for changes to the normal landscape of your bowel lining and removes anything that looks suspicious, like growths called polyps, which can lead to bowel cancer.

A colonoscopy is an invasive procedure that allows for the full examination of the lining of your bowel (colon and rectum), so make sure you fully understand the risks and benefits of having a colonoscopy before consenting to the procedure.

According to the Australian Commission on Safety and Quality in Health Care (ACSQHC), the quality of colonoscopy is critical to the early detection and treatment of bowel cancer and to minimising the risk of complications from the procedure.

Ensure your colonoscopist is experienced and interested in continuously improving the quality of colonoscopy care they provide.

Below is a list of questions to ask your colonoscopist to help ensure a high-quality colonoscopy. 

You can print a copy to take with you to your appointment.   

How many colonoscopies (%) have you performed in which one or more cancerous polyps (adenomas) were detected?   This percentage is referred to as a Colonoscopist’s Adenoma Detection Rate (ADR) and is considered the measurement that best reflects how carefully colonoscopy is performed.

How many colonoscopies (%) have you performed in which the colonoscope reached the very beginning of the colon (called the 'caecum')?    This percentage is referred to as a Colonoscopist’s caecal intubation rate and is considered an important indicator of colonoscopy quality.

Will my colonoscopy report include photographs of my caecum?   This will illustrate if the full extent of the bowel was examined.

Do you use split-dosing of bowel preparations?    Effective bowel preparation requires that at least half the preparation is ingested on the day of colonoscopy.

Will my colonoscopy report include details about the quality of my bowel preparation?   To ensure effective examination of the bowel it must be prepared according to the instructions accompanying the bowel preparation, otherwise polyps and cancers can be missed, and the colonoscopy may need to be repeated. 

Will my colonoscopy report include the colonoscope withdrawal time?   Longer colonoscopy withdrawal times have been shown to improve polyp detection rates, whereas rapid withdrawal of the colonoscope may miss polyps and reduce the effectiveness of bowel cancer prevention.


 *Ghanouni, A; Plumb, A; Hewitson, P; Nickerson, C; Rees, CJ; von Wagner, C; (2016) Patients' experience of colonoscopy in the English Bowel Cancer Screening ProgrammeEndoscopy, 48 (3) pp. 232-240.