Management of High-Risk Colonoscopy Patients

Rapidly evolving knowledge of the pathogenesis and natural history of colorectal cancer (CRC), especially in high-risk groups, is allowing the development of new tools to identify those who will benefit most from preventive measures. Currently, screening for adenomas, dysplasia, and early-stage invasive cancers provides the best opportunity to prevent and improve survival from CRC. Screening of high-risk groups almost always includes colonoscopy. This review discusses what represents quality colonoscopy. Proper risk stratification, understanding the natural history of each disease, proper patient counseling, and optimal techniques all help define quality colonoscopy in high-risk groups.