Risk factors for inadequate bowel preparation and quality improvement strategies in colonoscopy: a narrative review
- 1Sun Yat-sen University Cancer Center Gansu Hospital (Gansu Provincial Cancer Hospital), Lanzhou, China
Abstract
Colonoscopy is the gold-standard screening test for colorectal cancer, yet its diagnostic yield relies heavily on adequate bowel preparation. Despite standard protocols, 20%–30% of procedures still have inadequate cleansing, which lowers adenoma detection, prolongs procedures, increases repeat examinations, and wastes resources. Preparation quality is influenced by multiple interacting factors: patient characteristics (age, comorbidities, medication use, adherence), regimen features (purgative type, dose, split-dose scheduling), and healthcare delivery (education quality, appointment timing). Most previous studies have examined these factors in isolation, leaving a gap in integrated, evidence-based guidance. This narrative review synthesizes current knowledge on determinants of preparation quality, with emphasis on emerging strategies such as risk-stratified protocols, low-volume purgatives, digital health tools (mobile apps, SMS reminders), and AI-based real-time assessment. We aim to provide a practical framework for individualized preparation, thereby improving both the efficiency and quality of colonoscopy-based screening.
Related
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- Written Recommendation to Repeat Colonoscopy within 1 Year after Inadequate Bowel Preparation: A Simple and Highly Effective Intervention.
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BibTeX
@article{ma2026risk,
title = {{Risk factors for inadequate bowel preparation and quality improvement strategies in colonoscopy: a narrative review}},
author = {Shanshan Ma and Xinyu Zhou},
journal = {Frontiers in Surgery},
year = {2026},
month = oct,
doi = {10.3389/fsurg.2026.1969199},
url = {https://doi.org/10.3389/fsurg.2026.1969199},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Risk factors for inadequate bowel preparation and quality improvement strategies in colonoscopy: a narrative review
AU - Shanshan Ma
AU - Xinyu Zhou
PY - 2026
DA - 2026/10/13
JO - Frontiers in Surgery
DO - 10.3389/fsurg.2026.1969199
UR - https://doi.org/10.3389/fsurg.2026.1969199
AB - Colonoscopy is the gold-standard screening test for colorectal cancer, yet its diagnostic yield relies heavily on adequate bowel preparation. Despite standard protocols, 20%–30% of procedures still have inadequate cleansing, which lowers adenoma detection, prolongs procedures, increases repeat examinations, and wastes resources. Preparation quality is influenced by multiple interacting factors: patient characteristics (age, comorbidities, medication use, adherence), regimen features (purgative type, dose, split-dose scheduling), and healthcare delivery (education quality, appointment timing). Most previous studies have examined these factors in isolation, leaving a gap in integrated, evidence-based guidance. This narrative review synthesizes current knowledge on determinants of preparation quality, with emphasis on emerging strategies such as risk-stratified protocols, low-volume purgatives, digital health tools (mobile apps, SMS reminders), and AI-based real-time assessment. We aim to provide a practical framework for individualized preparation, thereby improving both the efficiency and quality of colonoscopy-based screening.
SN - 2296-875X
ER -